Student ID# (if known): _________________ Semester (Fall/Intersession/Spring/Summer): _______________ Year:____________
Last Name: ___________________________________ Legal First Name: __________________________ Middle Initial: ________
Complete this section only if you are new to the College or if there have been changes to your information:
Social Security Number: (required for 1098 tax reporting) __________ - ______ - __________ Date of Birth: _____________________
Preferred First Name: ______________________________ Email Address: ___________________________________________
□ Female □ I do not wish to report □ Are you seeking a degree/certificate at CCCC? Yes □ No □
Are you a US Citizen? Yes □ No □ Are you a Veteran? Yes □ No □
Mailing Address: __________________________________________________________________________________________
City: ___________________________________________________ State: _______________ Zip Code: ____________________
Mobile Phone Number: _______________________________ Alternative Phone Number: ______________________________
Do you consider yourself to be Hispanic or Latino?
Yes □ No □
Select one or more of the following groups of which you identify yourself as a member:
American Indian or Alaskan Native
□ Black or African American □ Cape Verdean □ Asian □
Hawaiian Native or Pacific Islander □ White/Caucasian □
Options to register for courses:
1. Online registration: If you are currently enrolled, you can register for classes using CampusWeb as the academic calendar and policy permit.
2. Registrar’s Office: Submit this completed form to the Office of the Registrar or email the form to email@example.com.
*Prerequisite Validation Codes: 1. Transfer Credit; 2. CLEP/AP; 3. CPT; 4. SIS. List only if prerequisite has been met through credit not reflected on the student record.
Advisor’s Name:_______________________________ Advisor’s Signature:______________________________________________
Student’s Signature:___________________________________________________________ Date: __________________________
Students must have advisor permission to enroll in any courses requiring a prerequisite.
Office of the Registrar – COURSE REGISTRATION FORM
2240 Iyannough Road │ West Barnstable, MA 02668
774.330.4711 │ Fax: 508.375.4084 │ firstname.lastname@example.org │ www.capecod.edu