Fillable Registration Form Non-Credit Training & Development (Cambridge College Massachusetts)

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Registration Form Non-Credit Training & Development (Cambridge College Massachusetts)

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The Registration Form Non-Credit Training & Development (Cambridge College Massachusetts) form is 1 page long and contains:

  • 2 signatures
  • 31 check-boxes
  • 38 other fields

Country of origin: US
File type: PDF

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Non-Credit Training & Development
Registration Form
Term
Fall Spring Summer Year:
If you have a Cambridge College student ID number, please write it in above.
Are you currently enrolled in a Cambridge College degree or certicate program? Yes No
Courses
Course #
example: WRT101
Section
example: CA01 Course Title Instructor
Program
(if applicable) _________________________________________________________________________________________________________________
Student information
PLEASE PRINT CLEARLY and COMPLETE ALL INFORMATION
Last name _________________________________________ First name _________________________________ Middle name _________________________
Current Residence:
Address ______________________________________________ Apt _____________________ Phone ___________________________________
City ______________________________ State _______________ Zip _____________________
E-mail home work _______________________________________________________________________________________________________________
Social Security number ____________________________________ Date of birth: Month ____________ Day ___________ Year ______________
Registrar's Oce
Cambridge College
500 Rutherford Avenue
Boston, MA 02129
Phone: 617.873.0101
Fax: 617.242.0026
registrar@cambridgecollege.edu
Signatures
Student signature
on paper printout or electronic* ____________________________________________
Date __________________________________________________________________
*Please see electronic signature options on the Registrar's web page
.
Program Coordinator
signature
_____________________________________________________________
Date _____________________________________________________________
Payment Type
Voucher
Credit card
Check/money order
Sponsoring
Organization
(if applicable) __________________________________________
After completing form submit it to:
Registrar's Oce
Cambridge College
500 Rutherford Avenue
Boston, MA 02129
Or email to:
registrar@cambridgecollege.edu
Or fax to:
617.242.0026
rev. 05/30/20
Demographic Information
Gender: Male Female Transgender Other
Are you Hispanic/Latino: Not Hispanic/Latino
Hispanic/Latino
Please check o one or more of the following
that best describes yourself:
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian/Other Pacic Islander
White
Prefer to not respond
Country of birth: _____________________________________
Country of citizenship: ________________________________
Are you an active member of the U.S. Armed Forces? or veteran?
Internal use only
Cohort code ______________________________
Student ID#________________________
Your Cambridge College Location
Boston
Lawrence
Springeld
Puerto Rico
Southern California
NEIB
Other_____________
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Registration Form Non-Credit Training & Development (Cambridge College Massachusetts)

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Completed 20 May 2021

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