Iowa Wesleyan College

Extended Learning Class Registration Form

*In order for an IWC full time day student to enroll in an evening or online Extended Learning class, the student must complete an ExL Course Registration form signed by their Academic Advisor, the Registrar and the Academic Dean.  Only after the completed form is returned to the Extended Learning Office will the student be registered for the course.  This can only be done in person and not on-line, thank you.

*ALL STUDENTS MUST HAVE AN IWC E-MAIL ADDRESS IN ORDER TO TAKE ANY COURSE THROUGH IOWA WESLEYAN COLLEGE.

First Name:

Last Name:
Address:
City:
State:
Zip:
Work Phone:
Home Phone:
Email Address:
Current Enrollment Status:
Enrollment Classification:
*
*
*
*
*
*
*
Apartment #:
Male
Female
*
SSN:
Student ID:
Have you attended IWC before?
Yes
No
If Yes, then when was the last term attended?
Part-time
Full-time
IWC Degree Seeking
Personal Enrichment
Audit
Other (S/U, Workshop, Etc.)
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Course Number:
Course Title:
Location:
Meets:
Are you taking other IWC Courses this term?
Yes
No
Day
Night
Cell Phone
Session:
Credit Hours:
@iwc.edu