Course Enrollment Form
Social Security Number
- - 		Birthdate (mm/dd/yyyy)
/ / 		Gender
male female
Last Name
 First Name
 Middle Name
Street Address (please include Apartment number if applicable)
City
 U.S. State
 U.S. Zip Code
Country (Required if not U.S.)
 		Foreign Postal Code
Phone Number
- 		Fax Number
-
Email Address (Required for web course enrollment)
 An ACT code is only required for high school students. You can get this number from your high school's counseling office or click here to find it online.. By supplying an ACT code, you give BYU Independent Study permission to inform your High School with your activity and grades in the course[s].
High school or university you are attending (if any)
 High School ACT Code
If you're using a printed version of the catalog, check our online catalog first for accurate information, especially for the 7-digit registration code. The online catalog is updated on a daily basis and contains the most current and correct information, which is not reflected in the print catalog.
Registration Code
7-digit number (refer to catalog)
Course 1    Course 2    Course 3
Textbook Order: If your courses require textbooks, you may purchase them from the BYU Bookstore or any other book seller. Make certain that the ISBN* number of the books you order matches the ISBN number of the required textbook. You must purchase the correct editions of the textbooks. The BYU Bookstore can help you identify and purchase the correct books. Visit them at http://byubookstore.com/ or call 1-800-914-8931 and press 2.
*ISBN: International Standard Book Number is a ten digit unique identifying number. The number is unique that that particular edition of a book, so if you use the proper ISBN number, you will have the proper edition of your textbook.