Wenatchee Valley College is committed to a policy of equal opportunity in employment and student enrollment. All programs are free from discrimination and harassment against any person because of race, creed, color, national or ethnic origin, sex, sexual orientation,
gender identity or expression, the presence of any sensory, mental, or physical disability, or the use of a service animal by a person with a disability, age, parental status or families with children, marital status, religion, genetic information, honorably discharged veteran or
military status or any other prohibited basis per RCW 49.60.030, 040 and other federal and state laws and regulations, or participation in the complaint process.
The following persons have been designated to handle inquiries regarding the non-discrimination policies and Title IX compliance for both the Wenatchee and Omak campuses:
• To report discrimination or harassment: Title IX Coordinator, Wenatchi Hall 2322M, (509) 682-6445, title9@wvc.edu.
• To request disability accommodations: Director of Student Access, Wenatchi Hall 2133, (509) 682-6854, TTY/TTD: dial 711, sas@wvc.edu.
WVC-R50A-03/20
WVC REGISTRATION FORM
Please write Student ID Number on front of check.
***If you would like to pay with a debit/credit card, please contact our Cashier at 509-682-6500***
Last Name First Name Middle Previous Name(s)
Mailing Address City State Zip
*Social Security Number Request
This information is used for several purposes:
To administer financial aid
To verify academic records
To conduct research
To report payments you made that may qualify for a tax credit or a tax deduction on your income tax return
In keeping with state and federal law, the college will protect your SSN/TIN from unauthorized use and disclosure. We are requir
ed to ask
for your SSN/TIN. If you do not submit it, you will still be able to enroll at the college, but you may be subject to an IRS penalty of $50.
__ Male __Female (Optional)
B. Date of Birth
_____/_____/_____
C. How long have you lived continuously in Washington?
____ years ____ months
D. Are you a U.S. citizen? ____ Yes ____ No
If no, check one of the following;
___ International Student __ Refugee __ Visitor
___ Permanent Resident
E. What type of program/degree are you intending to pursue at
this community college? (check one)
A __ Academic Non-Transfer Degree Program
B
__ Academic Transfer Program
(To UW, CWU, WSU, EWU, etc…)
__ Business __ Earth Science #1 __ Physical Sci
ence #2
__ DTA
D
__
Basic Education for Adults
F __ P
rofessional/Technical Program
(ESRT, AUTO, RADT, NURS, etc)
(List Program) ____________________________
H __ Apprenticeship Program
I __ Applied Baccalaureate Program
(List Program) ____________________________
J __ Upgrading Job Skills Courses
L __ Non-Award Seeking Student
F. W
h
at is your purpose for attending this communi
ty
college?(c
heck
one)
11 __ Take courses related to current or future work.
1
2 __ Transfer to a four-year college/AAS Degree.
13 __ High School diploma or GED.
14 __ Explore career direction.
15 __ Personal enrichment.
Quarter of Registration Year __________
__ Fall __ Winter __ Spring __ Summer
Telephone Number
Day: ________________
Evening:_____________
Type of Student
_
_ New __ Former
__ Returning from last quarter
____/____/____
