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Extension Online Registration Form

Use the form below to register for Extended Education classes and pay online. If you do not wish to pay online, or if you are having trouble with this form, please use the downloadable form and mail it to the address at the bottom of this form (Adobe Reader required). You may also call 707-826-3731 to register with a credit card (Visa, MasterCard or Discover).

NOTE: With the exception of online courses, this form can't be used to submit Open University
or Graduate Continuous Enrollment registrations.
Open University registrations must be entered on the downloadable form and brought to the first class meeting. The instructor's signature along with departmental approval is required prior to Extended Education processing the registration. Return the signed form with payment as soon as possible. Refer to the current semester's calendar to avoid late fees. For information regarding Graduate Continuous Enrollment registration, call Extended Education at 707-826-3731.

Those registering for OLLI courses should use the OLLI registration form.

Student Information

* = Required field

Select your gender:

Have you ever been enrolled at Humboldt State University?*

Have you completed a Bachelor's Degree or higher?*

Secure Information

Please supply the following information: Social Security Number/HSU ID and Date of Birth
This information is submitted via SECURE SERVER, and is requested pursuant to Section 41201, Title 5, Calif. Code of Regulation and Section 6109 of the Internal Revenue Code.

Social Security Number or HSU ID (000-00-0000):*

Your date of birth is required so that Humboldt State University may identify records that are unique to you.

*

Race/Ethnicity Information

Your voluntary response is requested to comply with Federal and State legislation. If the California State University system is asked to report only ONE summary race/ethnicity description for you, choose the ONE category below that you want us to report:

 
Courses

Enter the course information for the you want to take.

Course 1
Course 2
Course 3


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