Osher Class Registration

Hampton University

Billing Information

Are you a returning applicant? Yes No
Gender: Male Female
Are you an HU Alumni? Yes No
If you're an alumni, please provide your graduation year and degree:

Birth Date

Emergency Contact Name
Emergency Contact Phone
Ethnic Group (Optional)

How did you hear about the Osher Institute? (Optional)

Membership

Basic Membership dues are $50. Members may enroll in up to 3 classes per term for a registration fee of $50. Total fee for both options is $100.

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Payment Information

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