Workforce Development & Community Education

DO NOT USE FOR ESL REGISTRATION. SEE PAGE 67. Student ID | —- | —- | —- | —- | —- | —- | —- | —- | —- | Social Security Number | —- | —- | —- | - | —- | —- | - | —- | —- | —- | —- | Date of Birth | —- | —- | —- | —- | —- | —- | Last Name | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | First Name | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | Address | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | Apt # | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | City | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | State | —- | —- | Zip | —- | —- | —- | —- | —- | Home Phone ( —- | —- | —- ) | —- | —- | —- | - | —- | —- | —- | —- | Business Phone ( —- | —- | —- ) | —- | —- | —- | - | —- | —- | —- | —- | Fax ( —- | —- | —- ) | —- | —- | —- | - | —- | —- | —- | —- | Email Address —-—-—-—-—-—-—-—-—-—-—-—-—-—-—-—-—-—- Have you ever taken a class at WCC before?  Yes  No If yes, was it  credit  noncredit  Enclosed is my check, payable to Westchester Community College OR Charge to my  Visa  MasterCard  Discover Card No. —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | —- | Exp Date —-—-—-—- Approval Code No. —-—-— (from back of card) Signature —-—-—-—-—-—-—-—-—-—-—-—-—-—-—-—-—-—-—-—- EXPRESS REGISTRATION PHONE 914-606-6830, Press 1 MasterCard, Visa, or Discover ONLINE www.sunywcc.edu/MyWCC MasterCard, Visa, or Discover For info, visit sunywcc.edu/wdce FAX 914-606-6129 MasterCard, Visa, or Discover MAIL Continuing Education Westchester Community College 75 Grasslands Rd. Valhalla, NY 10595 MasterCard, Visa, or Discover or Check/Money Order IN PERSON Administration Bldg., Rm. 207 MasterCard, Visa, or Discover or Check/Money Order. NO CASH ACCEPTED. Open Mon.-Sat. Call 914-606-6830 and press 1 for hours. M M D D Y Y 0 0 0 CUSTOMER INFORMATION Refunds  For requests received at least 2 business days prior to the start of the class: 100% refund.  There are no refunds after that time.  The $5 registration fee is non-refundable. All refund requests must be made to the college in writing or emailed to workforceandcommunity@ sunywcc.edu . Most refunds are made by check; allow 4-6 weeks to be processed. If you registered online, your refund is immediately credited back to your credit card. Returned Check Fee The charge for a returned check is $25. CATALOG NUMBER SECTION CLASS NUMBER COURSE TITLE START DATE TUITION CE-COMP 1000 A #12345 Intro to Computers *Payable once each semester for non-credit courses. This fee is $4.75 for non-credit courses held at the Valhalla campus (materials fees are payable to the instructor at the first class). ** Required non-refundable fee; payable once each semester for non-credit students. ETHNICITY A variety of government agencies require that institutions of higher education report student enrollments by ethnic status. The information requested below will assist us in meeting this requirement. Please check the appropriate boxes. (Response is optional and does not affect your admission in any way.) Are you Hispanic/Latino?  Yes  No If Hispanic/Latino, please indicate which of the following would best describe your background? (select one)  Cuban  Dominican  Mexican  Puerto Rican  Other Hispanic/Latino Please indicate your race (select one or more)  American Indian or Alaskan Native  Asian  Black or African American  Native Hawaiian or other Pacific Islander  White Westchester Community College adheres to the policy that no person on the basis of race, color, creed, national origin, age, gender, sexual orientation or handicap is excluded from, or is subject to discrimination in any program or activity. Westchester Community College is an equal opportunity, affirmative action employer. *STUDENT FEE SEE NOTE TO LEFT **REGISTRATION FEE TOTAL ENCLOSED EX. $4.75 $ 5.00 Non-credit classes in this brochure, unless otherwise noted, are intended for adult students (18+) only.