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Registration Eligibility and
Personal Access Code (PAC) Request Form

    File this application if:
  • You are not currently enrolled in the University of Oregon as a regularly admitted student, or
  • You are a Community Education Program student who has not registered at the UO within the last year.

    To register for classes as a CEP student (eight credits maximum), you will need a Personal Access Code (PAC). Complete the information below, and submit the form. Your PAC and registration instructions will be mailed to the address you supply. See the Schedule of Classes or the CEP website to find out when CEP registration opens each term. CEP students are not eligible for financial aid.
Note: This form is for Fall, Winter, and Spring terms only!
If you want to take Summer classes, please follow this link and complete the Summer form.


UO Community Education Program Personal Access Code Form

Term Information

UO Enrollment Term Fall 2014

Name Information

Name:

  (LAST/FAMILY)
  (first)
  (middle)

Other Name(s):

Identification Number

UO ID number or U.S. Social Security Number:

(no dashes)
(Please read Social Security Number Disclosure Statement below.)

Degree Information

Indicate highest degree earned:

No Degree Bachelor's Master's Doctoral

Year degree awarded:

(YYYY)

Institution:

Attendance Information

Have you previously attended the UO?:

No Yes

If yes, year of last attendance:

(YYYY)

Citizenship Information

Are you a U.S. citizen?:

No Yes

If no, do you have a permanent resident card?:

No Yes

Residency Information

In what state do you reside:

How long have you lived in that state?:

years months

Personal Information

Gender:

Male Female

Date of Birth:

Month Day Year MMDDYYYY format

Are you Hispanic or Latino?:

Hispanic or Latino
Not Hispanic or Latino

What is your race?:

(Choose one or more.)
American Indian or Alaskan Native
Asian
Native Hawaiian and Other Pacific Islander
Black or African American
White

Contact Information

Address Line 1:

Address Line 2:

City:

State:

Zip:

(no dashes)

Country:

Telephone:

Area Code Phone (no dashes)

eMail Address:

Social Security Number Disclosure and Consent Statement
You are requested to provide voluntarily your social security number to assist the Oregon University System (OUS) in developing, validating, or administering predictive tests and assessments, administering student aid programs, improving instruction; internal identification of students; collection of student debts; or comparing student educational experiences with subsequent workforce experiences. When conducting studies OUS will disclose your social security number only in a manner that does not permit personal identification of you by individuals other than representatives of OUS (or the organization conducting the study for OUS) and only if the information is destroyed when no longer needed for purposes for which the study was conducted. By providing your social security number, you are consenting to the uses identified above. This request is made pursuant to ORS 351.070 and 351.085. Provision of your social security number and consent to its use is not required and if you choose not to do so you will not be denied any right, benefit, privilege provided by law. You may revoke your consent for the use of your social security number at any time by writing to: Office of the Registrar, 5257 University of Oregon, Eugene, OR 97403-5257.

I certify that I have considered each question carefully and that my statements are true and complete to the best of my knowledge. Further, I understand that enrollment at University of Oregon may be denied if any information is found to be incomplete or inaccurate.


For additional information, please visit the CEP home page
Additional Resources: (All resource links will open in new windows.)

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