Non-Degree Application

Non-degree seeking students who are taking a Mansfield University course for the first time must complete this application/registration form.

A one-time, non-refundable/non-transferable application fee of $25 must accompany this form. You may pay your application fee online by accessing our secure site after submitting this application or mail your check (made payable to MU) to:

Admissions Office
Mansfield University
71 S. Academy St
Mansfield, PA 16933


Students admitted to the University in a degree program must follow registration procedures outlined in the Registration Schedule & Instructions.



*Student Last Name:   *First Name:    M.I.:

Social Security No.: (xxx-xx-xxxx)
The Federal Privacy Act of 1974 requires that you be notified that disclosure of your Social Security Number is voluntary and is not required to determine admission. Your Social Security Number will be used to match your application with your SAT/ACT Test Scores and/or Financial Aid information so failure to provide it may affect your eligibility for financial aid and may delay decision of admission. Your Social Security number is also used to report your educational expenses to the Internal Revenue Service to verify any education-related deductions you may claim on your federal income taxes.

*Gender: Male   Female      *Date of Birth:

Area Code/Home Phone:      Cell Phone Number: (xxx-xxx-xxxx)


*Permanent State Address:

*City:   *State:   *Zip Code:

County: Length of Permanent Residence:

Local Mailing Address (if different from Permanent address above):

Street: County:

City:  State:  Zip Code:

Daytime Phone:  Home Phone:

*Email Address:


Last Name(parent, guardian, spouse):    First Name(parent, guardian, spouse):

Legal Address of Parent, Guardian, or Spouse:


City:    State:    Zip Code:

Relationship (parent, guardian, spouse):


Name of High School:

Street Address of High School:

City:     State:     Zip Code:

Date of High School Graduation (month/year):

*If not a high school graduate, do you possess a GED? Yes    No

If yes, Date GED earned (mm/yy):

For Veterans: Date of Service     Branch of Service:


*Are you a United States Citizen?: Yes   No

If no, what is your Visa status?


*Semester & year you wish to enroll in at Mansfield University:


*Do you plan to commute or live on campus? Commute   Live on Campus

*Enrollment Category:

Non-Degree student taking undergraduate credit courses for enrichment.
Transitory. non-degree student planning to/already attending another college/university. will transfer MU credits to that college/university after attending here one semester or more
College Bound. High school juniors & seniors taking MU undergraduate coursework through the College Bound Program.
External Certification. Undergraduate non-degree student taking courses to fulfill external (non-MU) certification programs.
Post Baccalaureate Enrichment. Post baccalaureate student taking undergraduate coursework for enrichment.
Distance Ed (Technology). Non-degree student taking distance education coursework only.
Visiting Student. A student taking coursework at MU who is enrolled in a degree program at one of the SSHE sister schools.
An undergraduate or graduate student who has not been accepted to the University by either Admissions or Graduate Studies who is requesting to audit coursework only.
International non-degree students taking distance education coursework only.

*Have you attended any post-secondary institution, including MU? Yes   No

If Yes, list Name/ Location/Dates of Attendance/Major/Degree/Date Received(mm/yy) for each institution in the order of attendance:

*Are you currently attending the last institution mentioned? Yes   No

Ethnic/Racial Identification:

We ask each applicant to provide information about his/her ethnic & racial background. We use this information solely to help us in determining whether the university is being successful in its efforts to assure equal opportunities to all persons. Please select the appropriate ethnic & racial identification below:

What is your ethnicity?

What is your race? Mark one or more races to indicate what you consider yourself to be:


Course Registration

For course information, please access Registration Information:


Enter Session, Course Prefix, Course Number, Course Title, Course Meeting Times, Course Credits
(Example: IA-THT 1110 01 Intro to Theatre, Mo/We/Fr 9 am, 3 credits) :


*ACT 48: Is this course being taken to satisfy the Commonwealth of Pennsylvania Act 48 regulations?   Yes   No

If yes, you are responsible for selecting courses applicable to your area of certification or your job assignment.


Where did you hear about Mansfield University or this program?

Admissions Counselor
College Search Website, i.e. College Board, Hobsons, etc.
Mansfield University Web site
Teacher/Guidance Counselor
Web search

Other (please list)


NOTE: Applications may not be reviewed until the application fee has been received. Completed applications are process in the order they are received on a first-come, first served basis. You are responsible for checking course prerequisites.

Send Questions / Comments to Amy Smith or call 1-570-662-4204