Fillable EWD Registration Form (Brunswick Community College)

Fill Online, Printable, Fillable, Blank EWD Registration Form (Brunswick Community College) Form

Use Fill to complete blank online BRUNSWICK COMMUNITY COLLEGE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

EWD Registration Form (Brunswick Community College)

On average this form takes 11 minutes to complete

The EWD Registration Form (Brunswick Community College) form is 1 page long and contains:

  • 0 signatures
  • 36 check-boxes
  • 27 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Brunswick Community College

BROWSE BRUNSWICK COMMUNITY COLLEGE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
*The Brunswick Community College Annual Security Report can be found at http://www.brunswickcc.edu/public-safety/.
Datatel # _____________
Contract # _____________
COURSE TITLE:
LOCATION:
START DATE:
HOW DID YOU HEAR ABOUT THIS CLASS?
☐CHOICES
☐BCC Website
☐Social Media
☐Other ___________
SSN
LAST
FIRST
MI
MAILING ADDRESS
CITY
STATE
ZIP
HOME PHONE:
MOBILE:
COUNTY:
E-MAIL ADDRESS:
DATE OF BIRTH:
☐Female
☐Male
☐White
☐Black
☐Hispanic
☐Asian
☐Native American
EDUCATIONAL LEVEL
_____ Non Graduate
(Enter highest grade completed 0-11)
☐High School Graduate
Name of HS ________________
Year _____
☐GED Diploma
☐Adult High School Diploma
☐Vocational Diploma
☐Associate Degree
☐Bachelor’s Degree
☐Master’s Degree or Higher
VETERANS STATUS
☐Active
☐Honorable Discharge
☐Reserves
☐Retired
Employed
☐1-10 hours
☐11-20
☐21-39
☐40 or more
Unemployed
☐Seeking
☐Not Seeking
☐Retired
Tuition Fee Waived:
Emergency Services Agency:
____________________________________
Other:
____________________________________
☐Paid
☐Volunteer
TUITION REFUND POLICY
Refunds are allowed under the following circumstances
A student who officially withdraws, in writing, from an occupational extension class
prior to the first class meeting or if a class is cancelled shall be eligible for a 100% refund.
After class begins, 75% shall be refunded at the request of the student if the student
officially withdraws, in writing, from the class prior to or at the 10% point of the
scheduled hours of the class. Note: This rule is applicable regardless of the number of
times the class meets or the number of hours the class is scheduled to meet.
For contact hour classes, students must withdraw, in writing, within 10 calendar days.
Self-Supporting classes will refund 75% to the student with an official withdrawal from
the class prior to the start date. No refunds will be issued after the start date of class.
If a student, having paid the required registration fee for a semester, dies during that
semester (prior to or on the last day of examinations of the course the student was
attending), all registration fees for that semester will be refunded to the estate of the
deceased.
PERMISSION TO RELEASE PHOTO FOR PUBLICATION
☐YES
☐NO
HRD TUITION AND FEE WAIVER – VERIFICATION STATEMENT
The State Board of Community Colleges grants permission to waive tuition and fees for enrollment in classes
coded in the Master Course List/Combined Course Library (MCL/CCL) as Human Resource Development if the
individual meets one of four criteria listed below. To receive this waiver, an individual must verify that he/she
meets at least one of the criteria by completing and signing this form.
I qualify for a tuition and fee waiver under the following criteria:
☐I am currently unemployed.
☐I have received notification of pending layoff.
☐I am working and eligible for the Federal Earned Income Tax Credit.
☐I am working and earn wages at or below 200% of the federal poverty guidelines.
STUDENT SIGNATURE:
If your check is dishonored or returned for any reason, we will electronically debit your account for the amount of the check plus a processing fee of $25.00
DATE:
CONTINUING EDUCATION, ECONOMIC & WORKFORCE DEVELOPMENT REGISTRATION FORM
VA Benefits can not be used to pay for CEWD courses.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

EWD Registration Form (Brunswick Community College)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 26 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document