WCSU Concurrent Enrollment Application
Student Information
Legal First Name
Middle Name
Last Name
Preferred / Nickname
Email
(
not your HS email address
)
Confirm email address
Contact Information
Street Address
Apartment/Suite/Other
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Zip Code
Cell Phone
(xxx-xxx-xxxx)
Home Phone
(xxx-xxx-xxxx)
Student Biographical Information
Date of birth (mm/dd/yyyy)
Race
American Indian
Asian
Black, not of Hispanic origin
Hispanic
White
Other
Gender
Female
Male
U.S. Citizen
Yes
No
Non-resident alien
Course Information
Select your High School
Bethel High School
Danbury High School
New Fairfield High School
Bethel Course Options
(select a maximum of 11 credits)
Public Speaking - Gina Riccio-Bronn - Earns 3 credits for WCSU COM 160
Danbury Course Options
(select a maximum of 11 credits)
AP Biology (S2) - Emma Mesanovic - Earns 4 credits for WCSU BIO 104
AP Biology (S2) - Alan Lounsbury - Earns 4 credits for WCSU BIO 104
AP Biology (S2) - Nicole Gurney - Earns 4 credits for WCSU BIO 104
AP Chemistry (S2) - Victoria McClelland - Earns 4 credits for WCSU CHE 111
AP Calculus BC (S2) - Sarah Dacres - Earns 4 credits for WCSU MAT 182
New Fairfield Course Options
(select a maximum of 11 credits)
AP Calculus BC (S2) - Ryan Pilner - Earns 3 credits for WCSU MAT 182
Confirmation
Registration PIN
(required before submitting)
Have you ever registered for any other WCSU course before?
Yes
No
Does your family qualify for the Free or Reduced Lunch Program?
Yes
No
What is your student ID? (looks like 50xxxxxx)
Can we send you text messages?
Yes, I agree to receive application-related and marketing messaging from Western Connecticut State University at the number provided above. I understand I may receive up to several messages a month and that data rates may apply. reply STOP to opt out
Acknowledgement
I acknowledge that the information provided above is accurate.
By completing this registration form, I acknowledge that I am registering for a WCSU course. The grade I earn in this course will be included on my permanent WCSU transcript. If I choose to withdraw from this course, I must do so before December 15th for fall courses, or by May 15th for full-year or spring courses. Withdrawing from the course will lead to a GPA-neutral "W" on my transcript instead of a grade.
Contact Information
