* = Required Field
  • Main Campus Enrollment Form
    for Adult & Online Education Courses

  • Current Home Campus Location
  • Enrollment Request
    • Where is the intended course being taught?

  • Spring 2019 Registration begins on Nov 28, 2018 at 10 AM
  • Attach Complete PDF with Signatures
    Forms will not be accepted/processed without a FULLY COMPLETE attachment. 
      • Forms will not be accepted/processed without a FULLY COMPLETE attachment. 
        Blank forms can be found here: online.campbell.edu/student-resources/main-campus-students/
    • Personal Information
      • Example: fdroosevelt01230@email.campbell.edu

      • - -

        (If applicable)

      • [Example: MATH 111 - KLIEWER, SUZETTE]

    • FA/TA/VA Acknowledgement

      • This Enrollment Request may impact your financial benefits. It is your responsibility to update all applicable information.
        For example: 
        • GoArmyEd
        • Veterans Affairs [VA]
        • Financial Aid [FA]
        • Tuition Assistance [TA]
        • Etc
        I agree to pay the remaining balance owed by the end of the semester for which I have registered. I understand that my account balance at the applicable Adult and Online Education Campus reflects the anticipated amounts of financial aid I am expected to receive. I agree to be financially liable for the amount of any financial aid if my application for these funds is denied. I also understand and agree that should I withdraw after the end of the published ADD/DROP date specified in the term schedule, I will be responsible for the full tuition fees whether or not I attend class. If I fail to pay the remaining balance by the end of the semester for which I have registered, the entire unpaid balance will immediately become due and payable as well as legal fees, 12% per-annum service charge and collection costs incurred as a result of non-payment, and Campbell University may report the unpaid debt to the credit bureau. Campbell University may institute further actions to include withholding university services, such as registration privileges, diploma and/or transcript releases.
    • By signing and submitting this form:
        • I understand that this request is not automatic and/or guaranteed and will be processed in the order forms were received. 
        • I understand this change may affect my financial aid, TA, VA, tuition charges, full-time status, and/or impact a variety of other factors.
        • I understand that it is my responsibility to contact the appropriate offices that may be affected by this request. [Financial Aid, Business Office, TA Counselor, VA Counselor, etc]
        • I understand the severity of both cheating and plagiarizing, as well as the possible consequences. I understand that it is my responsibility to ensure the work that I turn in is only mine. I also will not knowingly help anyone to break Campbell University's academic honor code. 
        • I understand that with this change I am held to the policies and requirements of the applicable Academic Catalog

      • [mm/dd/yyyy]