Graduate Visiting Student FormThis form is intended for individuals seeking to enroll as non-degree visiting graduate students at Delaware Valley University. Non-degree visiting graduate status permits eligible students to register for up to nine (9) graduate credit hours without formal admission to a graduate degree or graduate certificate program.Enrollment as a non-degree visiting graduate student is designed for individuals pursuing graduate-level coursework for professional development or academic preparation prior to applying for admission to a graduate degree or graduate certificate program. Coursework completed under non-degree status may be considered for transfer or application toward a future graduate program, subject to institutional policies, program requirements, and approval by the academic program.Submission of this form does not constitute admission to a graduate degree or certificate program. Students intending to continue beyond nine graduate credit hours must apply for and be admitted to an appropriate graduate program in accordance with University admissions policies.Personal InformationFirst NamePreferred First NameLast NameOther Last Names Used Social Security Number (providing your social security number is not required, but is highly recommended to help maintain accurate records). BirthdateBirthdateJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember123456789101112131415161718192021222324252627282930312026202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900GenderFemaleMaleAre you Hispanic or Latino?YesNoRace/Ethnicity (Please select one or more of the following):American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhiteContact InformationCell Phone NumberEmail AddressMailing AddressMailing AddressCountryStreetCityRegionPostal CodeAddress TypeMailing AddressPermanent AddressIntended EnrollmentStart TermAnnualFallSpringSummerWinterStart Year20172018201920202021202220232024202520262027202820292030Program TypeGraduate CertificateDoctoralMastersHave you ever taken classes at DelVal before?Have you ever taken classes at DelVal before?YesNoGR DelVal Level of Study (hidden field)GraduateHigh SchoolUndergraduateGenerate PIN (hidden)YesNoApp Submitted Flag (hidden)YesNoRound Always Create (hidden)YesNoProspect Type (hidden)Center for Learning and Retirement (CLR)CertificateDoctoralFirst-Time FreshmanHigh School Visiting StudentHigh School Visiting Student - No CredentialsMastersMasters 4+1Part-Time UndergraduatePersonal EnrichmentProfessional Development/Career TrainingTransferVisiting - GraduateVisiting - UndergraduateYouth Programs/CampsApplicant Type (hidden)Center for Learning and Retirement (CLR)CertificateDoctoralFirst-Time FreshmanHigh School Visiting StudentHigh School Visiting Student - No CredentialsMastersMasters 4+1Part-Time UndergraduatePersonal EnrichmentProfessional Development/Career TrainingTransferVisiting - GraduateVisiting - UndergraduateYouth Programs/CampsApp Round (hidden)CPSCPS HistoricalCPS21FRFRGRGR-InactiveGrad HistoricalHistoricalRATRTRSubmit