Registration Form for Non-Degree-Seeking Students

For Non-Degree-Seeking Students Only
(Degree-Seeking Students Must Register with an Academic Advisor)
Note: You must submit a separate form for each term for which you wish to register.

I wish to register for the term and year below (example: Spring 2021):

C-GCC ID Number (if known) or Social Security Number (numbers only, no hyphens):

First Name (required):

Middle Name or Initial:

Last Name (required):

Former Name:

Date of birth mm/dd/yyyy (required):

Legal Sex:
MaleFemaleX

Gender Identity:
MaleFemaleXOther:

Is English your native language?
Yes - English is my native languageNo - English is not my native language

Primary language spoken at home:

Please indicate your current citizenship status (required)
I am a United States CitizenI am a Permanent Resident of the U.S.I am not a U.S. Citizen nor a Permanent Resident of the U.S.

Select one or more options below that best describe your race or ethnicity
WhiteBlack or African AmericanNative Hawaiian or Other Pacific IslanderAsianAmerican Indian or Alaska Native
I am Hispanic/LatinoI am not Hispanic/Latino
If you indicated you are Hispanic/Latino, please select one option below:
Central AmericanPuerto RicanMexicanDominicanSouth AmericanOther Hispanic/LatinoNot Hispanic/Latino

Current Email Address (required):

Preferred Phone Number Including Area Code (required):

Is this a cell phone? Yes

Mailing Address

Street or P.O. Box (required):

City (required):

State/Territory (required):

Zip Code:

County (required):
ColumbiaGreeneDutchessUlsterRensselaerAlbanyOut of StateOther county not listed:

Permanent Residence Address

Street and Number (required):

City (required):

State/Territory (required):

Zip Code:

County of Residence (required):
ColumbiaGreeneDutchessUlsterRensselaerAlbanyOut of StateOther county not listed:

Select the high school you last attended from the drop-down list:
Other High School Not in ListCairo-Durham High SchoolCatskill Senior High SchoolChatham High SchoolCoxsackie-Athens High SchoolFaith Christian AcademyGermantown Central SchoolGilboa-Conesville Central SchGreenville Jr-Sr High SchoolHawthorne Valley SchoolHudson High SchoolHunter-Tannersville Central HSIchabod Crane High SchoolKingston High SchoolNew Lebanon Jr/Sr High SchoolRavena-Coeymans-Selkirk High SchoolRed Hook High SchoolRhinebeck High SchoolSaugerties Senior High SchoolStissing Mountain Jr-Sr HSTaconic Hills Central HSWebutuck High SchoolWindham Ashland Jewett Central School

If you selected Other High School Not in List above, please enter the name of the high school you last attended:

Please provide the city/town and the state of the high school indicated above

High School City/Town: High School State:

High school graduation month: 01-Jan02-Feb03-Mar04-Apr05-May06-Jun07-Jul08-Aug09-Sep10-Oct11-Nov12-DecI did not graduate
High school graduation year (YYYY format - enter zeros if you did not graduate):

Have you taken college courses AFTER you graduated from high school or received your GED? If yes, please enter the most recently attended college, and the city/state where it is located (required)
No - I have not taken college courses after high schoolYes - I have taken college courses after high school

Enter Course Requests Below (total credits must be no more than 11)
Course information may be found on the class schedule page. Inaccurate course information may delay your registration.

1. CRN Number (required):
1. Course Title (required):
1. Course Credits (required):
1. I would like to take this course for: (required)
CREDITAUDIT (no credit earned)
1. I have met the course pre-requisites as follows (include pre-requisite course information and institution where completed):

Comments

Please read and check the boxes next to each of the acknowledgements below.

(Required) I understand that I am responsible for having completed any appropriate prerequisite courses prior to enrollment in the requested courses.
(Required) I understand that this is a REQUEST to register for the classes I have selected, and that there may be reasons why I cannot be registered in the selected classes, including, but not limited to space availability, previous outstanding obligations to the college, and/or incomplete information submitted on the form.
(Required) I agree to pay any tuition and fees associated with the courses I have requested above, if I am registered for them.

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