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Online Registration Form

Workforce Development Online Registration Form

Please fill out all the required information. To register for an online course please go to Online Courses.

mm/dd/yyyy
Gender
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)
Disciplinary Dismissal
Have you ever been dismissed from a college for disciplinary reasons?



Please be advised that a prior felony conviction may impede the ability of a student to complete the requirements of certain academic programs and to meet licensure for certain professions.


Credit Card
Please charge my



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