High School Summer Sessions Registration

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Select Courses

Department:

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Student Profile

Fall 2026 Grade:*

9th Grade 10th Grade 11th Grade 12th Grade

Student First Name:*

Student Middle Initial:

Student Last Name:*

Student Social Security Number:

(123456789)

Student E-mail Address:*

(You will receive email once transaction is completed.)

Student Home Street Address:*

Student Home City:*

Student Home State:*

Student Home ZIP Code:*

Student Home Phone Number:*

(5165551212)

Student Date of Birth:*

Student Gender:*

Female
Male
Other

Please Specify:

Have you ever taken a course at, or affiliated with, Adelphi University previously? * Yes No

Do you have an Adelphi University ID number? * Yes No

Parent or Legal Guardian Information

Parent/Guardian #1:

Parent/Guardian #1 First Name: *

Parent/Guardian #1 Middle Initial:

Parent/Guardian #1 Last Name: *

Parent/Guardian #1 E-mail Address: *

Parent/Guardian #1 Phone Number: *

Parent/Guardian #2:

Parent/Guardian #2 First Name:

Parent/Guardian #2 Middle Initial:

Parent/Guardian #2 Last Name:

Parent/Guardian #2 E-mail Address:

Parent/Guardian #2 Phone Number: