REGISTRATION FORM for Noncredit Courses:
• Have you applied and been admitted? If yes, use this form to register for noncredit classes.
• Did you take noncredit classes last semester? If yes, use this form to register for noncredit classes.
• Please print clearly. Complete and sign this form. ONLY ONE PERSON PER FORM. The form may be duplicated.
• Do not mail cash. Check or credit card information will be accepted by U.S. mail or in-person. Make check payable to: “AHC
Community Education.”
• You may submit completed form in form, mail via U.S. mail, fax to 805-352-1046 and send as an attachment to
CommunityEducation@hancockcollege.edu
For U.S. mail, send completed form to:
Allan Hancock College, Community Education, Bldg. S
800 South College Drive, Santa Maria, CA 93454-6399
For more information call 805- 922-6966 ext. 3209, call toll-free 1-866-DIAL AHC (342-5242) ext. 3209, or visit
www.hancockcollege.edu/communityed
Have you attended Hancock before? YES NO AHC Student ID: H _________________________
Legal Name (First Middle Initial Last) Birth Date (Month/Day/Year):
Mailing Address:
Home phone: Is this a mobile phone? YES NO
Alternate phone: Personal Email Address:
Student Signature: Date:
METHOD OF PAYMENT:
CHECK. CREDIT CARD. Select one: Visa MasterCard Discover American Express
If paying by credit card and/or FAXING a registration form, all credit card information (below) MUST be completed.
Credit Card # Exp. D
ate Security Code:
Print Name on Card:
Credit Card Street Address (number only) and Zip:
Authorizing Signature: Total Fees (if any): $
REV 10-2020
For Instructor Use Only (required when selected class is full): I authorize this student to add my class.
Signature: Date:
