Non-Degree Seeking Registration Form
13650 Apple Harvest Drive
Martinsburg, WV 25403
TEL: 304-260-4380
FAX: 304-260-4376
www.blueridgectc.edu
The non-degree seeking student enrollment form for admission is for students who:
do not want to receive a degree; do not need Financial Aid, and only want
to take a few classes.
To enroll as a non-degree seeking student, the student needs to fill out the one-page
application form with chosen courses.
Students will be notified via e-mail when the registration form is processed.
Student Information
Last Name:
First Name:
Middle Name:
Address:
City:
State:
Zip Code:
Birth Date:
Telephone:
E-mail:
County:
Male Female
Gender:
HispanicBlack or African American
Asian
White
Pacific Islander
American Indian
Native Hawaiian
Alaska Native
Ethnicity (check all that apply):
Years lived in WV:
High School/GED Information:
Check payable to Blue Ridge CTC
Credit Card (Call 304-260-4380 ext 2214)
Payment Information:
Social Security:
Blue Ridge Community and Technical College provides opportunity to all prospective and current
members of the student
body, faculty, and staff on the basis of individual qualifications and merit
without regard to race, color, sex, sexual preference, religion, age, national origin, sexual orientation,
marital or parental status, familial status, veteran status, or disability.
Earned a High School Diploma
Earned a GED
Currently in High School (must provide letter from
the county school board from which registered)
No High School Diploma or GED
Yes No
Yes No
If yes, please contact our Veteran Education Coordinator at
vetsource@blueridgectc.edu to discuss this matter further.
Signature and Date:
By signing this form I acknowledge that I have reviewed and understand the policies on the back of this application.
Revised: 2/8/17
CRN Subject
Course
Number
Section Day(s) Time Course Title
Credit
Hours
Course Registration Information
Please complete all blocks for each course desired.
Test scores (ACT/SAT/Accuplacer) scores are required for
placement into certain courses such as MATH, ENGL, and
Chemistry.
There are also many courses that have prerequisite courses.
Check the comment section on the class schedule.
Year will Graduate:
City of HS:
Name of HS:
Year:
Year:
City of HS:
Name of HS:
Veteran Status:
(this info is optional and used for statistics only)
Have you ever served in the United States
Military to include the National Guard Reserve?
Will you be applying for VA benefits to help pay
for your college education?
Print Form
Collection of Social Security Numbers
Publicly funded schools and those that receive federal funding must comply with the Family Educational Rights and Privacy Act in order to
retain their funding. FERPA is also known as the "Buckley Amendment," enacted in 1974. Public schools, colleges, and universities that ask
for your SSN fall also within the provisions of the Privacy Act of 1974 and FERPA. The collection of SSNs are only for student identification
and are kept confidential. Blue Ridge Community and Technical College maintains the security of your SSN by using computer generated
Student ID numbers and not using any portion of the students SSN.
WV Residents 65 Years of Age and Older
Senior Citizens over the age of 65 may attend classes at a reduced rate for credit classes and $12.50 per credit for audit classes. Senior
Citizens wishing to register at the reduced rate must register as a non-degree seeking student and pay at the time of registration.
Auditing a College Course
Same fee as charged to enrollees taking respective course for credit. (the only exception applies to persons over age 65, see above).
Special Permission
If special permission or approval is required to register for a course, students must see the designated person listed in the Schedule of Classes.
The appropriate department enters the special permission override information, and then the student can register via BRIDGE.
Closed Classes
If a course is closed the student can then check other sections of the same course for available openings .
Time Conflicts
If a student requests two courses whose start and/or end time overlap, written permission is required from both instructors.
Other Conflicts
Students cannot register for two sections of the same course.
Registration Holds
Students with outstanding financial/other obligations will not be permitted to register until all obligations are cleared by the appropriate
office(s).
Maximum of 19 Credit Hours
Students may register for a maximum of 19 credit hours per semester.
Refund Policy
Students who completely withdraw from all courses in accordance with College procedures may receive a refund of tuition and fees in accordance with the
refund schedule. The refund calculation is based on the amount paid toward tuition and fees. Refunds are determined from the first day of the school term,
which officially begins with Orientation and Registration Days. The official withdrawal date is certified by the Registrar. Refund checks are issued through
the State Treasury, and receipt of a refund may take up to six weeks depending upon the date of withdrawal.
THERE IS NO REFUND ON PARTIAL WITHDRAWALS.
IRS Statement:
Blue Ridge CTC is an eligible educational institution, and must get your correct identifying number (Social Security Number or Individual Tax Identification
Number) to file certain information returns with the IRS and to furnish a qualified tuition and related expenses (Form 1098-T) statement to you. Your
signature signifies your understanding and consent that the College will provide your information to the IRS.
Blue Ridge Community and Technical College provides opportunity to all prospective and current members of the student
body, faculty, and staff on the basis of individual qualifications and merit without regard to race, color, sex, sexual preference,
religion, age, national origin, sexual orientation, marital or parental status, familial status, veteran status, or disability.
Building /Location Codes
HQ = Main Campus (Apple Harvest)
TC = Technology Center (Rt 11)
MO = Morgan County Center
OL = Online Course
RC = Ramers Center
CT = Hollywood Casino
QG = Quad Graphics
Days
M = Monday
T = Tuesday
W = Wednesday
R = Thursday
F = Friday
S = Saturday
U = Sunday