Name Street Address City State Zip The University / University of Missouri / UNIVERSITY SELF-PACED COURSE APPLICATION S&T / University Attended Name / CAMPUS YES MU UMKC Missouri S&T UMSL NO Department School/College / Please Obtain Required Signatures UNIVERSITY OF MISSOURI STUDENTS / Initials/date University of Missouri / University of Missouri Student Number / UM campus / University MAY / Clark Hall / / /
IndustryTerm
selfpaced@missouri.edu WEB online.missouri.edu Course Title Course Number / Online Web Site Other Web Site / selfpaced@missouri.edu WEB online.missouri.edu / Online ID / Online Course Listing / selfpaced@missouri.edu WEB online.missouri.edu UNIVERSITY SELF-PACED COURSE APPLICATION S&T / /
Organization
Normal A-F Univ Department / Previous College / High School / University of Missouri Student Number / High School City/State High School / Univ Department Course Number Univ / University of Missouri / Active Duty Military / CAMPUS YES MU UMKC Missouri S&T UMSL NO Department School / Obtain Required Signatures UNIVERSITY OF MISSOURI STUDENTS / / /
U[removed]Clark Hall Columbia, MO[removed]PHONE[removed]or[removed]FAX[removed]