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Step 2. Register For Classes

Class Registration Form (STAP)

Health Improvement Program

Use this form to register for STAP classes that you will pay for with STAP funds. To register for a class, please complete the following information (or include it on the form you will be asked to send in). Click on the "Submit" button once you have completed this form.

NOTE: In order to use STAP funds you MUST provide your employee ID (8-digit number located on your Faculty/Staff ID, NOT your SUNetID). According to University admin guidelines you must obtain approval from your supervisor when using STAP funds. You do not need your supervisor's signature.

(* = Required Fields)

Class Registrant Information

*Name:

First	MI	Last

*Gender:

*E-Mail Address:

Employment Information

*Employment Status:

*Employee ID:

(Eight-digit number located on your Faculty/Staff ID. Your employee ID should be 8 digits long. If your employee ID is 9 digits long, please drop the first leading 0.

*Department :

Mail Code:

(4 digits)

*Campus Phone:

eg. (650)725-0000

Fax:

*Health Plan:

Contact Information

Home Phone:

eg. (650)725-0000

Address:

City/State/ZIP:

Class Information

This form allows you to "pre-register" for a maximum of three classes at a time. If you want to sign-up for more classes, you can complete the process for the first three classes and then return to this page and repeat as necessary.

*ClassID1:
ClassID2:
ClassID3: