UNIVERSITY COLLEGE
University of Maine System


Certificate in Liberal Arts (Level I)
Certificate Enrollment Form

The Certificate in Liberal Arts (Level I) is awarded to students who successfully complete designated courses in six general subject areas. At least three of the six courses must be taken within the University of Maine System. An overall minimum grade point average of 2.0 is required for the six courses. Consult with your academic advisor for selection of appropriate courses.

INSTRUCTIONS: Complete this Certificate in Liberal Arts (Level I) Enrollment Form. Return the form to the Center Director, Student Services Coordinator, or Campus ITV Coordinator.

Name (Please print):_____________________________________________________________________

Street:________________________________________________________________________________

City:______________________________________ State:__________________ Zip:_________________

Home Phone:_______________________________ Date of Birth:_________________________________

Social Security Number:___________________________________ Sex:____________________________

Start Date: _______Fall _____Spring _____Summer Year:_________


Signature:________________________________________________Date:_________________________

I would like to receive Admissions information from the following University of Maine System campuses (check all that apply):
_____University of Maine
_____University of Maine at Augusta
_____University of Maine at Farmington
_____University of Maine at Fort Kent
_____University of Maine at Machias
_____University of Maine at Presque Isle
_____University of Southern Maine

Office Use Only: Distribution of CERTIFICATE IN LIBERAL ARTS (LEVEL I) Enrollment Form:
1. Center serving site.
2. Registrar's Office of campus serving site.
3. Admissions Offices checked above.