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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
[email protected]

Printable PDF Version


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.

Please mark only one of the following degree or certificate with an “X”:

Students may pursue more than one certificate or degree, however one must be marked as the primary program of study. Mark the primary choice with a (1) and the secondary with a (2), do not mark more than two programs of study.
Non-degree seeking(not eligible for financial aid)
Associate in Arts (Indicate one emphasis area)

Agriculture
Arts, Communication, Humanities, and Design
Business
Education
Science, Technology, Engineering, Math
Public Service
Health Sciences
Industry, Manufacturing, Construction
Social and Behavioral Sciences, Human Services

Associate in Science(For those transferring into a Bachelor’s degree program with Math and Science Concentration)
Associate in Arts in Teaching

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, Sport Management
Business & Technology, Technology
Computer Science & Information Systems
Criminal Justice
Diagnostic Medical Sonography
Early Childhood Development
Emergency Med Tech/Paramedic
Fire Science
Industrial Technology
Medical Assistant
Medical Laboratory Technology
Nursing
Occupational Therapy Assistant
Pharmacy Technology
Radiology Technology
Surgical Technology

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
Sport Management Essentials

Important information about the educational debt, earnings, and completion rates of students who attended this certificate program has
been made available to me.

Associate in General Studies (not available for students who have completed an Associate or Bachelor’s Degree)
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 [email protected].

North Central Missouri College’s consumer information is available for your review on NCMC’s Consumer Information.
Paper copies of consumer information are available upon request to the Dean of Student Affairs at (660) 359-3948.

R 08/13/19