Request for Information

Thank you for your interest in North Country Community College! Please provide a little more information about who you are and how we can assist you.

First Name

Last Name

Email Address

Phone Number

Can we text you?

Yes

No

Mailing Address

Country

Street

City

Region

Postal Code

My preferred method of communication is:

Email

Texting

Phone Call

Mail

What best describes you?

Future North Country CC Student!

Current or Previous North Country CC Student

School Counselor, Community Partner, Agency, Organization, or Other

Parent, Guardian, or Mentor

Date of Birth

Have you served in the United States Military or are you a dependent of someone who has served or is serving in the U.S. Military?

Yes

No

Thank you for your service! Please select your current status.

Name of High School

What type of student are you?

Name of College/University

When would you like to begin taking classes at North Country CC?

Other academic interest(s) not listed above?

Are you interested in learning more about on-campus housing (available in SARANAC LAKE)?

Yes

No

Are you interested in playing a sport at North Country CC?

Yes

No

NJCAA Athletic Programs available at NCCC:

Men's Basketball

Men's Soccer

Women's Basketball

Women's Soccer

Other athletic interest(s) not listed above:

Additional questions or requests:

How can we assist you? Please select all the apply.

Other requests not listed above:

Name of Student/Future Student

Relationship to Student:

Questions and/or requests from North Country CC:

Name of School, Organization, Agency, etc. you are affiliated with:

Your title/position:

Is this request in regards to a North Country CC student or future North Country CC student?

Yes

No

Name of Student/Future Student

Questions and/or requests from North Country CC:

How did you hear about North Country CC?

Having trouble filling out this form? Contact the Admissions Office at admissions@nccc.edu!