Spring Activation Request

 
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* = Required Fields
Date:*
First Name:*
Middle Name:
Last Name:*
Previous Name(s) if any:
Street Address:
City, State, Zip:* ,
Home Phone:
Work or Cell Phone:

E-Mail:*
Date of Birth: (MM/DD/YY)*
Male   Female
If you check this box, we will not verify any of your information by telephone. All verification will be done in writing and confirmed by your signature.
Ethnicity (optional): American Indian or Alaska Native
Black/African American
Hawaiian/Pacific Islander
Chicano/Mexican American
Asian
White/Caucasian
Latino/Latina
Other (specify):
Country of Citizenship:*
Citizenship Type:*
If other, please specify:
Have you previously attended Gonzaga? * No Yes Year:
Previous Enrollment: Full Time Part Time Summer Session
Non-Matriculated Distance Learning/Online
Dual Enrollment
Degree(s) previously earned:*

Associate Degree in: From: Year:

Bachelor's Degree in: From: Year:

Master's Degree in: From: Year:

Doctoral Degree in: From: Year:

Juris Doctor (J.D.) Degree in: From: Year:

No degree(s) obtained
How did you hear about Spring Sessions at Gonzaga? Facebook The NW Inlander GU Website Letter
Other (specify):
Working Toward:* Degree Major
Personal Development
Transferring Credits to Other Institution (specify):
Other (specify):
What level coursework are you interested in taking?:* Undergraduate-level (099-499)
Graduate-level (500-699)
Doctoral Degree (700-799)
Juris Doctor (LAW)
Military Veteran Status: Non-Veteran
Military Veteran not eligible for benefits
Military Veteran eligible for benefits
Have you ever been convicted of a crime,
or is a crime currently pending against you?
No Yes (explain):