Non-credit Registration Form

*Items preceded by an asterisk are required.

(Choose correct term)     *Semester:  Year:(yyyy)

Last:    First: M.I.:
*Mailing Address:
Street: City: State: Zip:
Permanent Address:(if different from mailing address)
Street: City: State: Zip:


*Home Phone: ()-- Cell Phone: ()--
Business Phone: ()--

*E-mail Address:

*Sex: *Ethnicity 1: *Race:
  *Date of Birth: (mm/dd/yyyy)
1 SCCC is required pursuant to Section 806B of Regulation (45 CFR 80) to furnish the information requested to the U.S. Department of Education under Title VI, Civil Rights Act of 1964. This information will be used for statistical purposes only.

U.S. Citizen:

Last college attended prior to SCCC:

Please check this box if above information has changed since your last registration.

CRN# CFP or CFE Number Days/Times/Building/Room

Thank you for your submission. Once we have completed your registration you will receive a confirmation letter in the mail with payment instructions. Please call the Office of Workforce Development and Community Education at (518) 595-1101 ext. 3 or 4 with any questions.

Home pages throughout the college are maintained by a variety of departments and individuals; SCCC assumes no responsibility for the contents of all pages. All information on this website is subject to change due to budget, staffing, instructional or other institutional needs. For comprehensive information, consult our catalog.