Pathway to Success: Summer Start (PaSSS) Enrollment Form

Enrollment Reply Form

Student Information

First

Middle

Last

Suffix

Penn State ID number (9-Digit Number):

Preferred Phone Number

Preferred Email Address

Enrollment

By checking the box, I indicate my interest in participating in the Pathway to Success: Summer Start program at Penn State Fayette, The Eberly Campus. If I have not done so already, I understand that I must accept my offer of admission to Penn State by submitting the $230 acceptance fees by the deadline. I authorize the University to change my starting semester from fall 2020 to summer 2020.

Electronic Signature

By entering my first and last name in the box above, I agree to the conditions in this agreement. In addition, I affirm that the information shared on this form is true and correct.

Date