Barry University Registration Form

Semester/Year    Major       Degree Seeking  yes  no   
Term Code--For Office Use 

Barry University Student Number    Social Security Number 

Status at Barry University
Former Student    New Student 

Last Name    First Name    Middle Initial 

Local Address--Street, City and State, Zip 

Home Phone      Work Phone     
Fax      email address 

I AUTHORIZE BARRY UNIVERSITY TO RELEASE DIRECTORY INFORMATION AS OUTLINED IN THE SCHEDULE OF CLASSES UNDER "PUBLIC NOTICE".

CHECK ONE:    YES      NO 

Signature of Student      Date 

Copyright © 2003 Barry University
Last update: 2:55 PM 5/5/2003