Minnesota State University Moorhead Senior Citizen Registration Form

Submit the completed form along with a copy of your driver's license or identification card to the Minnesota State University Moorhead Registrar's Office. You can submit the form by mail to Owens Hall 210, 1104 7th Ave S, Moorhead, MN 56563. Alternatively, you can fax the form to 218.477.2941 or email it to Registrar@mnstate.edu. Ensure that all sections are completed accurately to avoid any delays in processing. It is advised to keep a copy of the submitted form for your records. Check your eServices account for billing information and to avoid any unpaid bills that could create a hold on your account.

Important dates for the form in 2024 and 2025 include registration deadlines and the start of each semester. Fall semester classes begin in late August, Spring semester in early January, and Summer semester in early June. Registration for senior citizens typically opens after the second day of each semester.

The purpose of the Senior Citizen Registration Form is to provide Minnesota residents aged 62 or over the opportunity to audit classes or receive course credit at Minnesota State University Moorhead. This form allows senior citizens to take advantage of reduced tuition rates and continue their education in a supportive environment. By completing and submitting this form, senior citizens can gain access to a variety of educational opportunities and resources at the university.

• 1. Name: Full name including Last, First, and Middle.
• 2. Mailing Address: Street address along with City, State, and Zip Code.
• 3. Home Phone: Primary home phone number for contact.
• 4. Cell Phone: Mobile phone number for contact.
• 5. Date of Birth: Date of birth in mm/dd/yyyy format.
• 6. Student ID: Student identification number if known.
• 7. Email Address: Email address for communication.
• 8. Social Security Number: Social Security Number for record-keeping purposes.
• 9. Citizenship: Indicate whether you are a US citizen.
• 10. Gender: Specify your gender.
• 11. Residency: Confirm whether you are a Minnesota resident.
• 12. Ethnic Background: Specify your predominant ethnic or racial background.
• 13. Degree Seeking: Indicate whether you are seeking a degree at MSUM.
• 14. Course Auditing: Indicate if you will be auditing the courses.
• 15. Semester: Specify the semester you plan to take courses (Fall, Spring, Summer) and the year.
• 16. Proposed Class Schedule: Provide details about the classes you intend to take including Subject, Number, Course Title, Course ID, and Credits.

Failure to submit this form may delay your registration or record processing. Ensure all required information is provided and submitted on time to avoid inconvenience.

• Registration Delay: You may experience a delay in registering for courses until the form is submitted.
• Record Processing Delay: Your academic records may not be processed in a timely manner without the required information.
• Missed Educational Opportunities: Failing to submit the form may result in missed opportunities for taking desired courses.
• Inability to Audit Classes: Without the form, senior citizens may not be able to audit classes or receive credit.
• Billing Issues: Unpaid bills may create a hold on your account, preventing further registration.

• 1. Auditing Classes: When you want to audit classes for free without receiving credit.
• 2. Receiving Credit: When you want to receive course credit by paying an administrative fee.
• 3. Proof of Residency: When you need to provide proof of Minnesota residency and senior citizen status.
• 4. Course Enrollment: When you need to enroll in courses and submit personal and course information.
• 5. Reduced Tuition: When you want to take advantage of reduced tuition fees for higher education.