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Corporate College Non-Credit Registration Form

YOU MUST OFFICIALLY DROP A COURSE THREE WORK DAYS BEFORE IT BEGINS OR YOU WILL BE RESPONSIBLE FOR ALL FEES! ONLINE CLASSES ARE NOT REFUNDABLE ONCE THE STUDENT'S REGISTRATION IS PROCESSED.

Online registrations must be submitted no later than noon the business day before the class begins.

* Required Field

The college is required to have your correct SSN per IRS Code, Section 6109. ?
* SSN * LAST NAME   * FIRSTNAME   M.I.
 
* MAILING ADDRESS   * CITY   * STATE   * ZIP CODE  
 
* HOME PHONE   * WORK PHONE   * DATE OF BIRTH   * EMAIL ADDRESS  
   
Gender ETHNIC ORIGIN (Required by the Federal Government)
Are you Hispanic?
RACE: Choose one or more (for Non_Hispanics)



By entering my name in the space below, I understand that GCSC will provide my student information to the appropriate agencies for fee payment if I am not paying for this course and/or for licensure/CEU purposes, if required.
* Student Signature   Date

*****STATE REGULATED PROFESSIONAL LICENSE NUMBER***
CRN# COURSE # *COURST TITLE   DATE (MM/DD/YY) TIME FEE
$
$
$
$
$

$
Refund Information: All refunds are issued by check in the name of the student registered. Refunds are mailed to the student's address listed on the registration form. Refund requests must be received by 4:00 pm three workdays prior to the first day of class. Online classes are not refundable once the student's registration is processed.

If you need to copy of this registration form, please print from you browser menu prior to hitting submit.

You will receive an e-mail notification when your registration has been received with payment instructions. Your class registration will not be complete until the course has been paid. Thank you.