BROWN UNIVERSITY PHYSICAL EDUCATION

MAIL-IN Registration Form

Spring 2001 Semester — February 21 — May 8

  1. Individuals may ONLY register for Physical Education classes via this mail-in form. Form and payment must be received by February 14, 2001. Drop-in registration will not be accepted until after classes begin on February 21, 2001.
  2. You must hold one of the following to be eligible for the Brown University Physical Education Program:
    • Current and valid Brown University Identification Card
    • Current and valid Brown University Recreation Pass
  1. Anyone planning to park in the athletic center lot for classes must have a valid parking permit or pass. The Brown Physical Education Department will not take responsibility for any tickets you may receive.
  2. We accept personal checks, traveler’s checks or money orders for payment. CASH should not be sent via campus mail OR via the US postal service. Sorry, but we do not accept credit cards.	
  3. All courses are available on a space-available basis. Mail-in registration forms will be dated as they are received. On the date that the physical education office receives your form and payment you will be informed via E-mail/voice mail of whether or not you have received a spot in the class. Therefore, please do not call to check the status of your registration. If you do not receive a spot in the class you will be provided an opportunity to enroll in a second choice OR you may request full return payment.
  4. Please complete all of the information requested on the form. Your registration cannot be processed without all of the information.

Name______________________________________________	Brown ID #_____________________________________	

Campus/Home Address_____________________________________Campus /Home Phone #___________________________	

E-mail Address_________________________________________________________________________ ______			

Status:		Brown University Undergraduate Student (Class of _______)			Brown University Graduate Student		Brown University Faculty 							Brown University Staff				Brown University Recreation Member					RISD Student 					RISD Faculty 								RISD Staff

Class Name______________________________		Course #__________________________Fee	________

Class Name______________________________		 Course #__________________________Fee	________

Class Name______________________________		 Course #__________________________Fee	________

							 			Total amount enclosed $		

Refund Policy

*	Refund / Withdrawal period will begin on Wed. February 21, 2001 and end at 5pm on Wed. March 7, 2001. This deadline is strictly enforced.

*	All refund requests must be accompanied by the original receipt and will be pro-rated according to the date of the request. All requests must be made in-person at OMAC 101. The refund period ends on Wed. March 7, 2001.

*	Medical refunds must be accompanied by original receipt as well as appropriate documentation from the physician/health care provider. All medical refunds will be pro-rated according to the date of the request. All medical requests must be made in-person at OMAC 101.

It is understood that in signing this registration form, I am confirming that I have read all information contained on this document and agree to abide by all of the policies and guidelines described.

Signature__________________________________________________________Date______ ________________________________

Please enclose check or money order to:	Brown University

Send registration form to:			Brown University Physical Education Department

					Box 1933

					Providence, RI 02912

Direct questions or concerns to:		PhysEd@Brown.edu or call 863-2074