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North Country Community College
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Non-Degree-Seeking
Non-Degree-Seeking Registration
If you see this don't fill out this input box.
Semester
*
Please Select
Fall
Winterim
Spring
Summer
Select semester you are registering for
First Name
*
Middle Initial
Last Name
*
Other Name(s) Used
SSN
*
Enter Social Security Number
Street Address (Street, Town, Zip, County)
*
Enter (Street, Town, Zip, County)
Phone
*
E-mail Address
*
Emergency Contact Name and Phone Number
*
Enter Full name and phone number of emergency contact
Date of Birth
*
Gender
Enter your gender
Ethnicity
Enter your ethnicity
High School / Graduation Year
*
Enter High School Attended and Year Graduated
Have you ever enrolled for credit courses at NCCC?
Yes
No
Have you ever been dismissed from a college for disciplinary reasons?
Yes
No
Have you ever attended another college?
Yes
No
Name of college and degree earned if any.
Citizenship
*
Please Select
U.S.
Permanent U.S. Resident
Non-resident alien
Other
Select country of residence
If "Other" please enter Country name.
Country of residence
For the next section, please enter Dept Code, Course Number, Section Letter, Days, Times, Building/Room and Credits (separated by a comma). Enter one line for each course you want to take.
Each entry for a course should look something like this:
ENG, 102, T, MW, 8am-9am, DL, 3
MAT, 105, T, MW, 10am-11am, DL, 3
SOC, 101, T, F, 9am-12pm, TI-102, 3
Course Selection
*
Enter course information here
Total Credits
*
Enter the total amount of credits registered for
Payment Method
I would like to pay online
I would like to pay by check-by-mail
I would like to make payment arrangements
If online payment or check-by-mail is chosen, you will receive an e-mail with instructions on how to proceed after submitting request.
Verification
I am the individual requesting to be registered for the courses listed above.
I understand, that by signing this registration form, I am formally registered for the above indicated semester and have incurred a financial obligation to pay for these courses unless I formally drop the courses in writing prior to the start of the semester. I understand I will need to obtain a Certificate of Residence from my home County Treasurer’s Office within 30 days of the start of classes to receive In State Tuition.
Signature
*
Enter your full name - Parent/guardian signature if registrant is under 18 years of age.
Date
*
Enter today's Date
Submit
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Last Updated 11/15/20
Last Updated