WDCE Contract Training Registration Form

Montgomery College welcomes your participation in this customized training course. We use the information on this form to create and maintain your official transcript, a valuable career asset. Your name and information will be stored in our secured student database. Student information is not sold to commercial organizations.

Student Contact Information

First Name *This question is required.

Last Name *This question is required.

College ID Number (M#) if known

Email Address *This question is required. This question requires a valid email address.

Phone

Student birthdate *This question is required.

Street Address *This question is required. House and Street Name. (Do NOT use P.O. Box or you will be charged Non-Md Resident Fee)

City *This question is required.

State *This question is required.

Zip *This question is required.

1. Have you ever attended MC Before?

2. Ethnicity (Disclosure not mandatory by Montgomery College, but is required by the U.S. Department of Education)

3. Race: Choose all that apply, you may choose more than one. (Disclosure not mandatory by Montgomery College, but is required by the U.S. Department of Education)

4. Citizenship *This question is required.

5. If Other Immigration Status please list here:

5. Check all that apply

These questions pertain to Maryland residents as defined in the Montgomery College Catalog. Maryland residents who are 60+ years of age or older are eligible for a student discount for courses designated "Tuition Waiver Applies" TWA. Maryland National Guard members may be eligible for a tuition discount, but must submit proof of enlistment for 24 month period from the adjutant general's office.

I have been a Maryland Resident for at least three months.
I am 60 years of age or older and a Maryland Resident.
I am a Maryland National Guard member.

6. Select the Class(s) you wish to take from the list below: *This question is required.

CRN#12345 / Course# ABC123 / Introduction to working at home / start Date: April 4
CRN#54321 / Course# ABC123 / Intermediate working at home / start Date: April 4

7. For third party tuition. I authorize the release of addresses, grades and attendance reports to my sponsor or employer.

By submitting the online information, you agree to the following statement: I certify that this information is correct and complete. I agree to abide by the policies and procedures of Montgomery College.
*This question is required.

Type Student Name

8. Date *This question is required.

WDCE Contract Training Registration Form

WDCE Contract Training Form