Non-credit Course Request Form Columbia-Greene Community College Office of Community Engagement and Professional Development Note: You must submit a separate form for each term from which you wish to request classes. I am requesting registration for the term and year below (example: Spring 2021): C-GCC ID Number (if known) First Name (required): Middle Name or Initial: Last Name (required): Former Name (used previously at C-GCC): Date of birth mm/dd/yyyy (required): Current Email Address (required): Preferred Phone Number Including Area Code (required): Is this a cell phone? Yes Mailing Address Street or P.O. Box (required): City (required): State/Territory (required): Zip Code: County of Residence (required): ColumbiaGreeneDutchessUlsterRensselaerAlbanyOut of StateOther county not listed: Enter Course Requests Below (a maximum of three courses may be requested on this form) Course information may be found on the Non-credit classes page. Inaccurate course information may delay your registration. 1. Course Number (required): 1. Course Title (required): 1. Start Date (required - format mm/dd/yyyy): 2. Course Number (required): 2. Course Title (required): 2. Start Date (required - format mm/dd/yyyy): 3. Course Number (required): 3. Course Title (required): 3. Start Date (required - format mm/dd/yyyy): Comments Please read and check the boxes next to each of the acknowledgements below. (Required) I understand that this is a REQUEST to register for the classes I have selected, and that there may be reasons why I cannot be registered in the selected classes, including, but not limited to space availability, previous outstanding obligations to the college, and/or incomplete information submitted on the form. (Required) I agree to pay any fees associated with the courses I have requested above, if I am registered for them.