APOGEE Registration Form

Please complete, print, and fax to your department for advisor signature.

Date:

Term of Registration:

Social Security Number (use dashes):

Last Name:

First Name:

Degree Program:

Area of Specialization:

Street Address:

City:

State:

Zip Code:

PHONE NUMBERS:

Home:

Work:

FAX:

E-mail Address:

Course(s) for which you are enrolling:

Swearingen Engineering Center • Columbia, SC 29208 • 803.777.4177 • webmaster@engr.sc.edu