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STUDENT INFORMATION UPDATE

 
 
 

DO NOT RETURN BY FAX
Due no later than the Friday prior to the intended
term of re-enrollment.

Attn: Registrar’s Office
1301 Main Street
Trenton MO 64683
(660) 359-3948 ext. 1206
registrar@mail.ncmissouri.edu

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Returning students who have been absent from NCMC for at least one semester, but less than five years, and who did not graduate from NCMC are required to complete and submit this form prior to enrollment, and no later than the Friday prior to the intended term of re-enrollment. Students returning, after completion of a degree or certificate at NCMC, must complete a re-admittance form with the Admissions Office.

Social Security Number:                                      Student Id#:                       

Legal Name: (Last, First, Middle Initial, Maiden/Prior)                                                                                           

Permanent Address: (Number & Street, PO Box or Apt Number)                                     

(City, State, Zip, County)                                                                     

Primary Phone:                                      Alternate Phone:                                    

Email:                                                            Birth Date: (mmddyyyy)                      

Emergency Contact: (Last, First, Relationship, Phone Number)                                                                             

Residence Correction:
Tuition fees are based on a student’s permanent residence as defined by Missouri Dept. of Higher Ed. A separate form to request a change from previous records may be required, along with supporting documentation. Please contact the Registrar’s Office for information. Reduction of tuition rate may not be processed with this form.


Term you plan to return to classes at NCMC (mark only one):

Fall             Spring           Summer           
Year:20          

Term or date you last attended NCMC: (If longer than 5 years, a Re-Admittance Form is required)                  


E-Sign Act
Please choose to accept or decline to authorize receipt of electronic records and all electronic transactions completed between North Central Missouri College and you, an NCMC student. If you decline, all communication will be through paper records. You may experience processing delays. Your acceptance authorizes all electronic transactions while an NCMC student, including registration and payment online.

           Accept            Decline

Universities, College, & Vocational Technical Schools Attended:

Please request transcripts for any coursework taken since your last attendance at NCMC. Official transcripts must be received no later than the Friday before the beginning of the term enrollment is intended.

Send to Admissions at:

North Central Missouri College

1301 Main Street
Trenton, MO 64683

1.University/College/Vo-Tech                                                                             

City & State                                                                             

Credits Earned                                      Years Attended (YYYY – YYYY)                                     

 

2.University/College/Vo-Tech                                                                             

City & State                                                                             

Credits Earned                                      Years Attended (YYYY – YYYY)                                     

 

3.University/College/Vo-Tech                                                                             

City & State                                                                             

Credits Earned                                      Years Attended (YYYY – YYYY)                                     

 

Declaration of Degree and Program of Study:

Students should consult the current college catalog before declaring a degree and program of study.

I choose to be non-degree seeking:           
OR
           Associate in Arts (Indicate interest area            )
OR
           Associate in Arts in Teaching
OR
           Associate in General Studies (not available for students who have completed an AA, AAT or Bachelor’s Degree)
OR
           Associate in Applied Science (Indicate program of study below)

           Agriculture & Natural Resources
           Applied Technology (1+1 w. Tech Sch.)
           Behavioral Health Support
           Business & Technology, Business Management
           Business & Technology, Technology
           Computer Science & Information Systems
           Criminal Justice
           Dental Hygiene
           Diagnostic Medical Sonography
           Early Childhood Development
           Emergency Med Tech/Paramedic
           Industrial Technology
           Medical Assistant
           Medical Laboratory Technology
           Nursing
                                     Occupational Therapy Assistant
           Pharmacy Technology
           Radiology Technology
           Surgical Technology

OR
           Certificate (Indicate program of study below)

           Accounting/Business Tech
           Agricultural Business
           Business Management Essentials
           Business Technology Essentials
           Criminal Justice
           Crop Production
           Equine Management
           Financial Management
           Industrial Technology
           Industrial Maintenance Skills
           Livestock Management
           Manufacturing Skills
           Practical Nursing
           Pharmacy Technology

Signature:                                                                                 Date:                                     

Return by mail, in person, or scan into email from your NCMC-issued, pirate email no later than the Friday prior to the beginning of the intended term of re-enrollment.


Office Use Only:

Term, YR:                                      Advisor Assigned:                                                                                 Date:                                     

NCMC is committed to assuring equal opportunity to all persons and does not discriminate on the basis of race, color, national origin, sex, disability, religion, age, genetic information, veteran status, ancestry, gender identity or expression, or sexual orientation in its educational programs, activities, admissions, or employment practices as required by Title IX of the Education Amendments of 1972, Title VI of the Civil Rights Act of 1964, the Rehabilitation Act of 1973, the Americans with Disabilities Act, other applicable statutes and college policy. Sexual harassment, to include sexual violence, is a form of sex discrimination and is prohibited. Inquiries concerning these statutes and nondiscrimination policies should be referred to the Dean of Student Affairs, Dr. Kristen Alley, Alexander Student Center, 1301 Main Street, phone extension 1400 or kalley@mail.ncmissouri.edu.

North Central Missouri College’s consumer information is available for your review at on our website.

Visit NCMC’s Consumer Information

Paper copies of consumer information are available upon request to the Dean of Student Affairs at (660) 359-3948.

R 05/10/18