Summer College for Non-La Roche Students


The application below is strictly for application to the Summer College by non-La Roche students.  All applications are processed by the Registrar's Office.  Once received, you will be contacted regarding registration for classes.  If you have any questions, please email the Registrar's Office at registrar@laroche.edu.

Welcome to La Roche!
  * Fields in red are required.
First Name:
Middle Name:
Last Name:
Maiden Name:
(if applicable)
Gender:
Female     Male
Date of Birth:
(Format: mm/dd/yyyy)
Social Security Number:
Country of Citizenship:
   
E-mail Address:
   
Street Address:
 
City:
State:
Zip Code:
County:
   
Phone Number:
( ) -
   
Are you currently enrolled at another institution?
Yes     No
If yes, where are you currently enrolled?

Have you previously taken a class at La Roche College?
Yes     No
 
In which courses do you plan to enroll at La Roche?
PLEASE NOTE: For a list of courses in which you may enroll for the Summer (with meeting dates and times), CLICK HERE.
 
1.
2.
3.
4.
5.
6.
 

Questions/Comments:


Voluntary Information


What is your ethnicity?
What is your race?
If you selected multi-racial, please check all that apply
Amer Indian/Alaska Nat
Asian
Black/African American
Caucasian
Hispanic
Nat Hawaiian/Pac Island
Are you hispanic of any origin?
Yes     No
 

La Roche College provides reasonable accommodations to qualified students with disabilities in accordance to the Americans with Disabilities Act and the Rehabilitation Act. If you feel that you may need reasonable accommodations or other considerations during the Summer Program, please contact the Coordinator of Accessibility and Compliance at 412-536-1177 or accessibilityservices@laroche.edu.
Leave this field empty