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Online Registration Form

Continuing Education Online Registration Form

Please fill out all the required information.

mm/dd/yyyy
Male/Female


Ethnic Origin
A variety of government agencies require that institutions of higher education report student enrollments by ethnic status. The information requested in this section will assist us in meeting this requirement. Please check the appropriate box. Responses is optional and confidential will not affect your admission in any way.
Are you Hispanic/Latino?


If Hispanic/Latino, please select one of the following to indicate which best describes your background?





Please indicate your race (select one or more)
Do you have a prior felony conviction?


Have you ever been dismissed from a college for disciplinary reasons?



Felony/Disciplinary: A felony in New York State law is defined as a crime for which more than one year in prison may be imposed. The felony question applies if you have been convicted as an adult. I hereby certify that the above statements are true and correct to the best of my knowledge.

If you answer yes to either question you will receive a letter requesting further information. Answering yes to either question does not automatically bar an applicant from admission. A campus committee will then review information provided. You must answer this question. Failure to do so will suspend the processing of your application.


Please charge my



Guarantee

If you are not satisfied with a continuing education course, Rockland Community College will refund your fee or transfer it toward another continuing education course. You must notify the registration clerk prior to the second meeting of the course or prior to the afternoon session of a one-day seminar. Job Training, Health Professional courses and trips have a separate refund policy.

See the Rockland Community College catalog for refund policies for academic credit courses.

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