ASU at Lake Havasu Connect Now Learner Information
This form collects personal information to be submitted on behalf of the student for enrollment in ASU at Lake Havasu courses. The information in this form is personal and private and will only be shared with ASU. You only need to fill out this form once. You can take a maximum of 2 classes (up to 8 credits) through Connect Now. These courses are on-ground at ASU Lake Havasu and may require the purchase of a textbook.

This form enrolls you in your FIRST course only. Please visit https://havasu.asu.edu/connect-now to view available courses.

You will receive an invoice from ASU Prep Digital for the $99 class fee. You may see a temporary holding fee of $500 on your MyASU account, but that will disappear, so please do not pay it. Only pay the $99.  
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Student Last Name *
Student First Name *
Gender *
Are you Hispanic?  *
Student Race *
Birth Date (ex. 01/01/2001) *
Mailing Address (street address, city, state, zip) *
Student Email *
Student Phone Number *
Parent/Guardian Last Name *
Parent/Guardian First Name *
Parent/Guardian Email *
Parent/Guardian Phone Number *
Year in school *
Term (the term you will take your first class: ex. Fall 2022) *
Class Subject (ex. BIO, ENG, COM, CHM, CRJ, HST) *
Catalog Number (3-digits; ex. 100, 101, 105, 210) *
Units (course credits) *
Current School *
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