Senior Auditor Program Enrollment Form – Spring 2025

Thank you for your interest in the Penn LPS Senior Auditor Program. If you want to register for Spring term classes, please complete this form. You will be required to complete a Registration Request Form when the list of courses available for Spring 2025 is released on December 13th. By doing so, you'll ensure you receive the Registration Request Form as soon as the course list is posted. You can only receive a Registration Request Form after you complete this form.

Student Information

First Name

Middle Name

Last Name

Email Address

Date of Birth

Sex

Street Address

City

State

Zip Code

Mobile Phone

You will be subscribed to the UPenn Alert system.

Alternate Phone

Have you participated in the Senior Auditor Program before?

Yes

No

Are you a current or former Penn employee or faculty member?

Yes

No

Emergency Contact

First Name

Last Name

Street Address

City

State

Zip Code

Phone

Email