Non-Degree Registration Request

Please list all colleges/universities you have attended or have earn credit from (use additional space if needed):

College/University Name

Please list any additional colleges/universities you have attended if more than 3/not listed above:

Emergency Contact Information

Emergency Contact Full Name

Emergency Contact Phone Number

Non-Degree Course Registration Information

When would you like to attend North Country?

Where would you like to attend classes?

Please note: NCCC's Summer courses are all being offered ONLINE ONLY (no in-person or live-online class meetings).

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

You can view course offerings at: https://nccc.edu/registration/index.html.

Please list the course(s) you are requesting registration for:

Total number of credits you are requesting to register for:

Additional questions

Preferred Payment Method.* Full payment will be due prior to the first class.

I would like to pay online.

I would like to pay by check.

I would like to make payment arrangements.

Verification*

I am the individual named 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.

Electronic Signature*