LaGuardia Community College 2020-2021
Senior Citizen/ Non-Degree Application
Note: The City University of New York does not discriminate on the basis of age, sex, race, creed, color, national origin, physical or mental
disability, sexual orientation, veteran's status, and alienage or citizenship status.
Instructions: Please print clearly.
Please list course(s) you would like to register for:
Course #1: _ Course #2:
(Instructions for Transfer students ONLY)
a). You must meet the pre-requisite requirements for the course(s) you have listed above, before you are allowed to register.
b). Please submit your college transcripts with this application.
TERM: (check one) FALL I FALL II SPRING I SPRING II
(September) (January) (March) (Late June)
NAME:
Last First M.I. PRIOR (any prior last name used)
SOC. SEC. #: - - _ SEX: F M DATE OF BIRTH:
(month) (day) (year)
STREET ADDRESS:
Apt. #
CITY: STATE: ZIP CODE:
HOME PHONE: BUSINESS PHONE:
E-MAIL ADDRESS:_
Length of time at above address: Length of time in NYC in NYS _
US Citizen: yes _no Country of Citizenship: of Birth: _
If no, or or _
Alien Registration Number Immigrant status Other
(Note: Citizenship status and alienage are used to determine if any other educational documents are needed to evaluate your application.)
I hereby certify that all information in this application is accurate and complete. I realize that failure to file the
appropriate application may affect my admission status. I understand that all the information contained in this
application will be treated confidentially and will be used for institutional purposes only.
SIGNATURE: DATE:
OVER
EMPL ID: _______________
_________
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signature
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