REGISTRATION DATA FORM

This form is required to confirm your registration and process financial awards EVERY semester.

THE UNIVERSITY REQUIRES YOUR LOCAL MAILING ADDRESS.

To verify your Vanderbilt addresses or if you are a new student or you have moved or otherwise changed your mailing information, please go to the University Registrar web site and update your information before continuing. It is the student's responsibility to notify the University of address changes, in writing or via the University Registrar web site, as soon as possible. Mail sent to the address on file will be considered to have been delivered.

For what semester are you completing your registration? BE SURE YOU PICK THE CORRECT TERM!

First Name

Middle Initial

Last Name

SSN# (no spaces or dashes)

VUnetID

E-mail address

Anticipated Semester of Graduation from your Current Peabody Program

Advisor 1

Advisor 2

In Case of Emergency Contact:

Name

Address

City

State

Zip Code

Country (leave blank for US)

Phone

Relationship to Student

I certify that the information given on this form is complete and accurate. It is an honor code violation to submit this form for anyone other than yourself.

By submitting this form I verify that I am a Peabody Student in an M.Ed, M.P.P, Ed.D. or Special Student.