Intent to Enroll/ Orientation Registration Form Spring 2022

Intent to Enroll/

Orientation Registration Form

Students must complete this form by January 1, 2022

Greetings Lincolnites!

We are excited about you attending Lincoln University of Missouri (LUMO)! This form does two (2) things: 1) confirms your intent to enroll at Lincoln University and 2) officially registers you for our New Student Orientation.

Once you have completed the form and paid the enrollment fee, you will receive a confirmation email. The one time enrollment fee cost is $150 for new incoming freshmen and transfer students for the 2022-2023 academic school year. Payment of the enrollment fee is required before students are registered for New Student Orientation.

You can also submit payments to our Cashiers Office over the phone no later than January 1st, they can be reached at (573) 681-5085.

If you are not attending Lincoln University beginning in January of 2022, you do not have to complete this form at this time.

Should you have any additional comments or concerns email admissions@lincolnu.edu or call (573) 681-5102.

Personal Information

Student I.D. Number *

Your Student ID is located on your Acceptance Letter from the Admissions Office

Name*

First Name

Middle Name

Last Name

Date of Birth*

format: MM/DD/YYYY

Phone*

Email*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

High School / College you are currently attending name? *

Intent to Enroll

Select a block below to indicate your decision.*

What is you intended major?*

for example accounting, nursing, or education

T-Shirt Size*

College / University you plan to attend instead:

Reason(s) for declining

Orientation

Orientation Selection*

We offer online and in-person Orientations

Emergency Contact

(NON-TRADITIONAL students are eligible to list themselves as their emergency contact)

Emergency Contact Name*

First Name

Last Name

Emergency Contact Email*

Emergency Contact Phone Number*

Emergency Contact Relation*

Enrollment Fee Payment

There is a one-time non-refundable enrollment fee for ALL new and transfer students staying on and off-campus. $150 - The enrollment fee cannot be waived and must be paid by August 19th.

If you need to pay over the phone, please call our Cashiers Office at (573) 681-5054. If you need to mail in a check or money order, send it to:

P.O. Box 29

Jefferson City, MO 65101

For additional questions regarding this please call our Admissions Office at (573) 681-5102.

Are you staying on or off campus? *

Fee Payment*

Credit Card*

Cardholder Name*

First Name

Last Name

Billing Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Signature*

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Use your mouse or finger to draw your signature above