Student registration HiddenNext Steps: Install the User Registration Add-OnThis form requires the Gravity Forms User Registration Add-On. Important: Delete this tip before you publish the form.Personal informationName First Last Email Enter Email Confirm Email PhoneStudent numberYearDate of birth MM slash DD slash YYYY DepartmentHumanitiesScienceEngineeringMedicineEmergency contactName First Last Relationship PhoneEmail Scholarship statusAre you on a scholarship? Yes No Name of scholarship Student portal loginUsernamePassword Enter Password Confirm Password Consent I agree to the privacy policy.NameThis field is for validation purposes and should be left unchanged.