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GUEST STUDENT REGISTRATION FORM

Enroll

Do not use this form to make name, address, or program changes. Contact the Office of Records and Registration at summerregistration@camdencc.edu to make changes to an application that has already been submitted.



1. Term for which you desire admission

2. Title

3. Legal Name
Last
First
Middle
Maiden
Suffix

4. Other Name: (If applicable)
Last
First
Middle

5. E-mail Address

6. Home Address (Address where you reside in the US; do not use a P.O. Box)
Street
Apt No.
City
State
Zip
7. Mailing Address (If different from Home Address)
Street
Apt No.
City
State
Zip

8. County of Legal Residence

9. State of Legal Residence

10. Preferred Telephone Number ) -
Phone Type

11. Social Security Number* Required except for international students

*We are requesting your Social Security Number (SSN) for our system of student records as well as for compliance with federal and state reporting requirements. An SSN is not required to apply for admission, but not providing your SSN when applying for admission could result in a delay in matching materials submitted. The College will not disclose your SSN to anyone outside the institution except as required by law, and will make every effort to protect your privacy. Your social security number will be required at the time of registration.


12. Please enter the course information below (The first line is an example) Search for Classes
Session No. Subject/Course No. Title Credits Days Times

PREREQUISITE DECLARATION


I am aware the courses listed above for which I am registering may have one or more prerequisites.
I hereby certify the following:





Certification


I certify that the above answers are true, correct and complete to the best of my knowledge. If any statement is not true, I understand I will be held responsible. Further, I agree to abide by the rules and regulations of Camden County College as outlined in the College Catalog and the Student Handbook and other College publications.

     (mm/dd/yyyy)

Information on financial assistance, FERPA, graduation, completion, and transfer-out rates, as well as information on campus safety and security, including crime statistics, can be found on the Consumer Information link on the bottom of the College's home page at www.camdencc.edu.

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