Registration Request Form for Continuing Education Classes

Columbia-Greene Community College
Office of Continuing Education and Workforce Development

Note: You must submit a separate form for each term from which you wish to request classes.

I am requesting registration for the term and year below (example: Spring 2021):

C-GCC ID Number (if known)

First Name (required):

Middle Name or Initial:

Last Name (required):

Former Name (used previously at C-GCC):

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

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

Enter Course Requests Below (a maximum of three courses may be requested on this form)
Course information may be found on the Non-credit classes page. Inaccurate course information may delay your registration.

1. Course Number (required):
1. Course Title (required):
1. Start Date (required – format mm/dd/yyyy):

2. Course Number:
2. Course Title:
2. Start Date (format mm/dd/yyyy):

3. Course Number:
3. Course Title:
3. Start Date (format mm/dd/yyyy):

Comments

Where did you hear about our course offerings?
Paper catalogOnline catalogSocial mediaWord of mouthOther (please indicate below)

If you answered “Other” to the previous question, please indicate here where you heard about our non-credit course offerings.

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

I understand this is a request to register for the course(s) I have selected. Reasons why my registration will not be processes include, but are not limited to space availability, previous obligations to the college, and/or incomplete information submitted on the request form.
I acknowledge that by checking this box, The Office of Continuing Education and Workforce Development will contact me to finalize my registration and process my payment. I understand that I am not registered for any non-credit course(s) until payment is received.

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