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University of Iowa handbooks for new students, 1960-1968
Page 48
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125269 DOE JOHN A Acou. 1cl. 1_ _ _ _ 10 44 MON 2 30 Birth Date Time of Registration Amount Due 432 ELM ANYWHERE IOWA 19 77 19 ___3___3___ Home Street Address Hometown and state Dept. Major County Code in Iowa Religion Code Valid only For Mr. William Doe 432 ELM Anywhere Iowa (if codes Incorrect refer to reverse side of card) Parent/Guardian Parent/Guardian Street Address Parent/Guardian City & State IF INFORMATION PRINTED ABOVE IS INCORRECT STRIKE OUT AND ENTER CORRECTIONS Please Print all information clearly Is this your first registration at S.U.I YES_ NO_ If name changed since your last registration give former name ________________ Check type of residence DATE REGISTERED 1. Dormitory 2. Sorority or Fraternity 3. Univ. Married Housing 4. Living At Home 5. Off campus _Single _Married Address where you will be living while classes are in session ________________________ number, street, or rm. no, dorm Check if Iowa City ___OR check if commuting and give city _________ Iowa City phone ______ OR University extension ph. OR commuting phone_________ STATE UNIVERSITY OF IOWA COURSE TITLE (Leave a space between Courses) Dept. No Course No. Sec. Sem. Hrs. Lv. Blank Total Signature of Adviser Signature of Dean (if required) 48
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125269 DOE JOHN A Acou. 1cl. 1_ _ _ _ 10 44 MON 2 30 Birth Date Time of Registration Amount Due 432 ELM ANYWHERE IOWA 19 77 19 ___3___3___ Home Street Address Hometown and state Dept. Major County Code in Iowa Religion Code Valid only For Mr. William Doe 432 ELM Anywhere Iowa (if codes Incorrect refer to reverse side of card) Parent/Guardian Parent/Guardian Street Address Parent/Guardian City & State IF INFORMATION PRINTED ABOVE IS INCORRECT STRIKE OUT AND ENTER CORRECTIONS Please Print all information clearly Is this your first registration at S.U.I YES_ NO_ If name changed since your last registration give former name ________________ Check type of residence DATE REGISTERED 1. Dormitory 2. Sorority or Fraternity 3. Univ. Married Housing 4. Living At Home 5. Off campus _Single _Married Address where you will be living while classes are in session ________________________ number, street, or rm. no, dorm Check if Iowa City ___OR check if commuting and give city _________ Iowa City phone ______ OR University extension ph. OR commuting phone_________ STATE UNIVERSITY OF IOWA COURSE TITLE (Leave a space between Courses) Dept. No Course No. Sec. Sem. Hrs. Lv. Blank Total Signature of Adviser Signature of Dean (if required) 48
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