Non-Matriculated / Non-Degree Registration Request Form for non-matriculated/non-degree-seeking students to fill out to request to register. This form is term-specific. Use this form only to apply as a non-matriculated student. Non-matriculated students are defined as students who are not currently accepted into a degree program. If you are interested in matriculating and pursuing a degree from SUNY Polytechnic Institute, you are encouraged to apply through the Graduate or Undergraduate Admissions Offices. There is a one-time fee for non-matriculated applications of $25. (It will appear on your semester billing statement when you register.) Personal InformationName * Required First Middle Last Your Address * Required Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is this address your PERMANENT address? Yes, this address is my PERMANENT address No, this is my school-year/local address No, this is a temporary address PERMANENT Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Date of Birth * RequiredPlease enter your date of birth in MM/DD/YYYY format. MM slash DD slash YYYY Email Address * Required Home Phone * RequiredCellular/Mobile Phone * RequiredSex * RequiredOur computer system only allows the choice of "Male," "Female," or "Not Available." Male Female Not Available For what term are you requesting to register? * Required Review of non-matriculated applications for SUMMER 2023 will begin on APRIL 10, and for FALL 2023 on JULY 1. We will contact you regarding the status of your application after the review is complete to inform you of the outcome. Applications will be reviewed and responded to in the order in which they were received. SUMMER 2023FALL 2023Demographic InformationPlease indicate your race (select any/all that apply): * RequiredAs a State University, we attempt to collect demographic information on students registering, but you are under no obligation to submit this information. Submission or lack of submission of demographic information will have no impact on permission to register. American Indian or Alaska Native Asian African American or Black Native Hawaiian or Other Pacific Islander White/Caucasian I prefer not to answer Are you Hispanic/Latino? * Required Yes No I prefer not to answer If you are Hispanic/Latino, please select your background: Central American Dominican Mexican Puerto Rican South American Other Hispanic/Latino I prefer not to answer Have you been a permanent resident of New York State for the last twelve months? * Required Yes No Are you a U.S. citizen? * RequiredIf you have a "Green Card," please select "I am a Permanent Resident." Yes No I am a Permanent Resident What is your Resident Alien Number? * Required What is your Visa type? * Required F-1 J-1 H-1B Academic HistoryPlease indicate highest degree completed: * Required I am enrolled in high school High School diploma GED (or equivalent) I have taken some college coursework, but have not earned a degree I am currently enrolled in a degree program at another college/university Associate's Degree Bachelor's Degree I have completed a Bachelor's degree and am currently enrolled in a graduate program at another college/university Master's Degree Graduate Certificate of Advanced Study GED/Equivalency Date: College(s) Attended: * RequiredEnter one college per line. Use the + icon to add additional lines. Name of College/UniversityDate(s) AttendedDegree earned, if any High School Attended * RequiredName of High SchoolLocation (City and State)Date Graduated (or planned to graduate) Have you ever taken a course at SUNY Polytechnic Institute (formerly SUNYIT)? * Required Yes No When did you last attend SUNY Poly (formerly SUNY IT)? * RequiredPlease indicate semester and year (spring, summer, or fall, and year). What is your SUNY Poly ID# (U#)? Reason for choosing non-matriculated coursework (select the one that most closely describes your situation): * Required I am interested in taking a course before applying to the UNDERGRADUATE program at SUNY Poly I am interested in taking a course before applying to the GRADUATE program at SUNY Poly I need the requested course for graduation, but it is not offered at my school I have applied to matriculate in an UNDERGRADUATE-level program in the future and want to get a head start I have been approved to participate in the "Semester at SUNY Poly" experience at CNSE/Albany and have received advisement regarding course selection. I have applied to matriculate in a GRADUATE-level program in the future and want to get a head start I am repeating a course to increase my GPA I hope to use this course to qualify for a GMAT waiver To which program have you applied/do you plan to apply? * Required Is this a SUNY Cross-Registration request? * RequiredChecking "yes" on this form does NOT start the cross registration process. Approval for SUNY cross-registration/Financial Aid Consortium must be processed through the SUNY form: suny.edu/crossregister. Approval of the Cross Registration request is not technically necessary in order to register as a non-matriculated student, but if your home campus denies the Cross Registration request and you subsequently decide to cancel this request to register, please contact the Registrar's Office. For more information about cross registration, please visit our Cross Registration page. Yes No What is your Home SUNY Campus? * RequiredNote that we are using official institutional names; many SUNY campuses are listed under "State University College at [city]." If you don't find your campus listed where you expect, please check under "S." Adirondack Community CollegeAlfred State CollegeBinghamton UniversityBroome Community CollegeBuffalo State CollegeCayuga Community CollegeClinton Community CollegeCollege of Agriculture & Technology at CobleskillCollege of Environmental Science and ForestryCollege of OptometryCollege of Technology at CantonCollege of Technology at DelhiColumbia-Greene Community CollegeCorning Community CollegeDownstate Medical CenterDutchess Community CollegeEmpire State CollegeErie Community CollegeFarmingdale State CollegeFashion Institute of TechnologyFinger Lakes Community CollegeFulton-Montgomery Community CollegeGenesee Community CollegeHerkimer County Community CollegeHudson Valley Community CollegeJamestown Community CollegeJefferson Community CollegeMaritime CollegeMohawk Valley Community CollegeMonroe Community CollegeMorrisville Community CollegeNassau Community CollegeNew York State College of Ceramics at AlfredNiagara County Community CollegeNorth Country Community CollegeOnondaga Community CollegeRockland Community CollegeSchenectady Community CollegeStony Brook UniversityState University College at BrockportState Universtiy College at CortlandState University College at FredoniaState University College at GeneseoState University College at New PaltzState University College at Old WestburyState University College at OneontaState University College at OswegoState University College at PlattsburghState University College at PotsdamState University College at PurchaseSuffolk County Community CollegeSullivan County Community CollegeSUNY OrangeTompkins Cortland Community CollegeUlster County Community CollegeUniversity at AlbanyUniversity at Buffalo (UB)Upstate Medical UniversityWestchester Community CollegeRegistration RequestCourse(s) Requested: * Required4- Digit CRN (Course Reference Number)Course Subject (Ex: ENG, NSCI, CS, etc.)Course Number (Ex: 101, 215T, etc.)Section # (Ex: -01, -35W, -11H, etc.) NOTE: Use a separate line for each course/section requested. Click the "+" indicator to add additional lines for additional sections. CRN: The 4-digit Course Reference Number. This identifier is unique to each section. Subject: The 2-4 letter couse subject (ENG = English, CS = Computer Science, NENG = Nanoscale Engineering, SOC = Sociology, MTC = Mechanical Engineering Technology, etc.) Course: The 3-digit course number (may include a T or L for lecture/lab courses). For example: Freshman Composition: The subject is ENG and the course is 101. Statistical Methods: Subject is STA and the course Number is 100. Anatomy and Physiology I: Subject is BIO and the course number is 215T (lecture/theory) and 215L (laboratory). Section #: 2-3 digit course section number; may include a letter (usually W, S, A, B, C, or H). If the course you are requesting has prerequisites, you must submit a copy of your unofficial transcript. You may upload it via the link below or you may email it to nondegree@sunypoly.edu or fax it to 315-792-7802. If you are requesting a graduate level course, a transcript showing proof of Bachelor degree completion is required. Some courses require departmental/academic approval. This may delay approving your registration. Upload Unofficial Transcript hereTo prove completion of prerequisite courses, we will need to see your unofficial transcript. You may upload it to this form, or you may fax it to the Registrar's Office at (315) 792-7802. Max. file size: 50 MB.Required Information * RequiredHave you ever been dismissed from another college for disciplinary reasons? Answering "yes" to this question will NOT automatically prevent denial of your request; An applicant who responds "yes" will be requested to provide additional information for consideration which will be reviewed by a campus committee. Any deliberate falsification or omission of data may result in your request being denied. Yes, I have been dismissed from another college for disciplinary reasons No, I have never been dismissed from another college for disciplinary reasons By submitting this form, I acknowledge the following:As a non-matriculated student, I am ineligible from receiving federal and/or state financial aid (TAP, Pell, Federal Direct Student Loan, etc.) for courses taken at SUNY Poly. However, I may apply for a private student loan through a lender of my choice. I may contact the Financial Aid Office (315) 792-7210 for information. Coursework taken while in non-degree status may be applicable to the degree program upon formal admission, however, there is no guarantee of credit applicability or admission by completing coursework in non-degree status. A maximum of 16 undergraduate credit hours and 6 graduate credit hours is allowed as a non-matriculated student. As stated in SUNY Poly's FERPA policy: SUNY Poly may use certain information from this form for general publicity releases to the media. Photographs of students, faculty and staff taken on campus may be used to illustrate official college publications and advertisements. Students who wish to restrict release of biographic data information and/or photographs should follow the procedure outlined in the Student Handbook or contact the director of public relations, (315) 792-7113. Acknowledgement * RequiredI understand that I am not eligible for Financial Aid and that while coursework may apply to a future degree program, coursework taken as a non-matriculated student does not guarantee admission to a program at SUNY Poly, nor is there any guarantee made that courses taken will apply to a future degree program. I also understand that SUNY Poly's FERPA policy is published in the Student Handbook along with many judicial policies and procedures. 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