Middle Grades Institute Pre-Registration

If you need help completing this form or with the registration process, contact us or chat us below and we will be happy to help!

Pre-registration/Reactivation

Page 1

This form is for those intending to register for the following credit courses as part of the Middle Grades Institute.

EDML 3600 60146 Mid Grades Curric&Instruction
EDML 6990 61259 Mid Grades Instruct & Assessmn
EDML 6990 61258 Creating an Equitable ML Cmnty
EDML 6070 61143 Adoles Lrng&Beh&Cog Perspect
EDML 3700 61142 Middle School Org & Pedagogy

Contact Information

When do you anticipate beginning course work?

First Name

Middle Initial

Last Name

Please list any other names that you have used while attending UVM

This helps prevent duplicate student accounts

Confirm email

Match?

Your own email address?

I verify that this is not an email account that I share with another personFor example, if you and a sibling use the same email address, your accounts may become combined and cause registration delays

Country

Permanent Street Address

City

State

Zip Code/Postal Code

Permanent Phone Number

Mobile Number

Organization

Title

Hidden

Program Code

interest area

MGI

MGI trueadded 4/28/22 to accommodate middle grades initiative. Intended to be replaced with different interest code and attribute code, but that needs to be coordinated with reg office

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Student Citizenship

Are you a US Citizen?

YesNo

Do you have a social security number?

YesNo

Visa Status

I currently hold a non-immigrant visa.I will be applying for a student F-1 or J-1 visa.I have been granted permanent U.S. residency.Not applicable - I will not be entering the United States

Visa Type

ex. F-1; J-1; L-2; H-4

Alien Registration Number

Student Information

Social Security Number

Student Social Security Number (Encrypted for Privacy)

Enter with no dashes or hyphens (ex: 000000000)

Re-enter Social Security Number

Match?

Student Date of Birth

MM/DD/YYYY

Legal Gender

MaleFemale

Military Status

English proficiency

Is your first language English?

YesNo

Have you taken the TOEFL?

YesNo

Did you receive a TOEFL score of 90 or greater?

YesNoAn advisor may contact you regarding your English proficiency

Which of the following describe the reason(s) that you are pursuing education at this time?

Career advancementChange to a different career fieldMaintain licensure or certificationPrepare for a master's degreeVisiting graduate studentOther

Other reason for pursuing higher education

Do your future plans include applying as a degree seeking student at UVM?

YesNo

If so, to what college/school?

Misdemeanor, felony and disciplinary history

Have you ever been adjudicated guilty or convicted of a misdemeanor or felony?

YesNoNote that you are not required to answer "yes" to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise required by law or ordered by a court to be kept confidential.

Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from the 9th grade (or the international equivalent) forward, whether related to academic misconduct or behavioral misconduct, that resulted in a disciplinary action?

YesNoThese actions could include, but are not limited to: probation, suspension, removal, dismissal, or expulsion from the institution.

Please provide a detailed description of the incident. Additionally you will need to include the date, time and location of the incident as well as any sanctions made against you.

Race/Ethnicity

Hispanic or Latino

Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member:

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

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Prior course work at UVM

Have you ever taken a course at UVM before?

YesNo

Existing student information

In what semester and year did you take your last UVM course?

Semester

Year

Year that you took your last course at UVM

Audit

Are you planning to audit any courses?

Audit Terms Agreement

I understand that I will receive an audit form via email, and that the completed form must be returned to the registrar's office before the end of the add/drop period in order to audit a course.Check to indicate your understanding of the audit terms.

Degree program enrollment

Are you in a Degree Program at a US or Canadian Institution other than UVM?

YesNo

Welcome! We are pleased to have you as part of the UVM Community!

Please enter the name of your undergraduate institution

What is your major?

If your major is not listed above, please enter it here

Are you considered to be in good academic standing at the institution listed above?

YesNocumulative grade point average of 2.0 or higher

Please provide details on your academic standing.

Terms of Registration

I understand that by submitting course registration I am entering into a financial arrangement with UVM and I accept responsibility for all charges billed to my UVM account.
I understand that my UVM bill will be posted online in the UVM Student Information System and that all billing notices will be sent to my UVM assigned e-mail address and that it is my responsibility to review my bill. You may wish to review the electronic bill due dates.
I understand that I am responsible for tuition and other required add/drop and withdrawal procedures of the University, and that my non-attendance does not relieve me of any tuition or course charges. I understand that accounts not paid when due are subject to a late fee and a hold preventing registration and access to grades and transcripts. I further understand that seriously delinquent accounts may be placed with an outside collection agency or reported to the national credit bureau system. I agree to reimburse the University all collection agency fees, up to a maximum of 40% of the debt (or the highest amount allowed by law), together with attorney's fees and all other costs and charges necessary for the collection of any amount not paid when due. I understand that the University may review my credit file for the purposes of repayment.
I authorize the University and its agents and contractors to contact me regarding my account or repayment of my loan(s) at any telephone number I provide (including wireless numbers), using automated telephone dialing equipment or artificial or pre-recorded voice or text messages.

More information about tuition, fees, and UVM billing procedures

Terms of Registration Acknowledgement

I agree to the terms of registration

Credits earned at UVM are transferable at the discretion of the receiving institution.

By pressing the "Finish" button, I am certifying that to the best of my knowledge this information is true and correct.

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Would you like to be considered a Vermont resident for tuition purposes?

YesNoEven if you live in Vermont, you must complete this section in order to be considered for in-state residency status. In-state residency is based on UVM Residency Policy

⚠️Are you sure you do NOT want to be considered a Vermont resident for tuition purposes?

If you do want to be considered a Vermont resident for tuition purposes, go back one question and select "Yes".

Vermont Residency

Vermont Residency Questionnaire

In order to be considered for in-state tuition, you must complete this section. The final decision on residency is made by the residency office. Regardless of your responses below, it is the student's responsibility to understand their final residency determination before they register. The residency office may request additional information before determining residency status. All Applications for In-State Status should be received no later than the last day of the Add/Drop period for the semester for which in-state status is sought. All applications received after the Add/Drop period will be considered for the following semester for which the student is enrolled.

Learn more about UVM residency criteria

Have you attended a college or university over the past three years?

YesNo

Schools Attended

Complete for all colleges or universities attended during the past 3 years

If you have any difficulty entering schools in the drop-down menu, please use the "Additional colleges or universities attended" section below.

Choose state or province

Choose name of university

if school is not listed, enter below

Start date

MM/DD/YYYY (Date you began attending)

End date

Date you stopped attending-- enter planned end date if currently attending

Please list any schools not included above

List employers for the past 2 years, including address and dates, using the format below

For example:

IBM, Essex Jct VT, 5/2000-5/2005
Green Mountain Coffee Roasters, Waterbury VT, 6/2005-present

Have you been employed at any point during the last 2 years?

YesNo

Employers

Please list employers for the last two years below

Employer

Employer Name

City

State/Province

Start Date

MM/DD/YYYY

Are you currently employed by this employer?

YesNo

End Date

MM/DD/YYYY (list today's date if currently employed)

List the states in which you have filed resident income tax the last 3 years (see example below)

2015- Vermont
2014- Vermont
2014- New York

When was the last year you were claimed as an exemption by your parents for tax purposes?

In what state did you graduate from high school?

When did you first begin living in Vermont?

MM/DD/YYYY

Are you under 25 years of age?

YesNo

Which address do you reside at currently?

The Permanent address (that you entered on page 1)Other (please enter below)Parent/Guardian's address

Parent/Guardian Address

Street Address

City

State

Zip Code/Postal Code

Country

How long have you resided at your current address?

Enter years and months (i.e. 10 years, 2 months)

Other address

Other Street

Other City

Other State/Province

Other Zip/Postal Code

Other Country

For Vermont Residents Only: The information above does not change the residency status established at your last enrollment. For information on filing for in-state status, contact the Residency Office, Registrar's Office, 85 South Prospect St., (802) 656-8515.

Information is also available online under Policies & Procedures on the Registar's webpage.

Contact Information

Areas of Interest

Program Type

Learning Format

Credit Courses

For Students

For Employers

For Staff

Categories

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Address

Middle Grades Institute Pre-Registration

Pre-registration/Reactivation

Page 1

Page 2

Page 3

Terms of Registration

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Complete for all colleges or universities attended during the past 3 years

If you have any difficulty entering schools in the drop-down menu, please use the "Additional colleges or universities attended" section below.