Course Registration Form
NMCC ID # ________________________ Date of Birth ________________
if none Social Security# ______________________ Sex M F
Last Name__________________________ First___________________________ Middle_____________________
Mailing Address ___________________________________________________________________________________
Street/PO Box Town State Zip
Physical Address ___________________________________________________________________________________
(if different from above) Street Town State Zip
E-Mail Address________________________________________________ Cell Phone __________________________
Home Phone ______________________________ Work Phone______________________________
Maine Resident? Yes No U.S. Citizen? Yes No If No, what country? ____________________
Previous attendance at NMCC? Yes No Maiden/Previous Name while attending ____________________
(if different from above)
DESIRED COURSES Fall Spring Summer 20 ___
Course # & Section
Course Title
#Cr. Hrs.
Location
1.
2.
3.
4.
Where are you taking classes this semester? Presque Isle campus Other___________________________
Are you graduating from NMCC at the end of the semester for which you are now registering? Yes No
Major (if applicable)________________________________________________
Are you a senior citizen (65 years of age or older)? Yes No
Is the course you are taking offered through:
Concurrent Enrollment Yes No EMBARK Yes No
High School Aspirations Yes No If yes, MEDMS ID# required (available from guidance): __________________
Is a third party (i.e. employer, EMBARK, high school) responsible for paying for your course? Yes No
If yes, please list (be specific): _______________________________________________________
Military Status: Veteran (utilizing benefits) Active Duty Military Not Applicable
Veteran (not utilizing benefits) Veteran’s Dependent (utilizing benefits)
Ethnicity (Optional): Hispanic/Latino Not Hispanic/Latino
Race (Optional check all that apply): American Indian or Alaska Native Asian
Black or African American White
Native Hawaiian or Other Pacific Islander
I would like someone to contact me about additional opportunities at NMCC: Yes No
Student Signature _______________________________________________ Date_______________________________
PLEASE NOTE: Individuals with disabilities who require accommodations must contact the Counseling Office at (207) 768-2839 for assistance.
click to sign
signature
click to edit
College Rights
The College reserves the right to cancel course offerings, to set minimum and maximum size of classes,
and to change designated instructors in courses offered by Northern Maine Community College.
The College also reserves the right to refuse enrollment in courses if a student has a debt with the Maine
Community College System or if a student is not in compliance with the College or State of Maine
immunization policy.
Grades, transcripts, and other student records will not be released if a student has not met his/her
financial and/or other responsibilities to the College.
Add/Drop Policy
A student may add or drop any subject during the first week of any semester without academic or
financial penalty.
After the add/drop period (first week of each semester) through the 12
th
week of the semester, a student
may withdraw from courses and receive a notation of WP/WF on his/her record. A student leaving a
course without officially withdrawing will receive a grade of “F” in the course. This “F” grade will be
computed in the student’s grade point average.
Refund Policy
Students officially withdrawing (dropping) from a course(s) within the first six calendar days of the term
will receive a full refund. Courses officially dropped between the 7
th
and the 10
th
day of the semester will
result in a 50 percent tuition refund. Students dropping courses after the 10
th
day of the term will not
receive any refund.
A pro rata refund for tuition and assessed fees is also available to a student withdrawing completely from
all classes in a given semester/term. Please see current catalog, student handbook, or the NMCC website
for further information.
For assistance in completing the appropriate add/drop, withdrawal, or other forms, please contact the
Registrar’s Office. All student-related policies are available in the College’s student handbook and
current catalog, available online at the College website, www.nmcc.edu.
Northern Maine Community College is an equal opportunity/affirmative action institution and employer.
For more information, please call (207)768-2791.