Issue link: http://howardcc.uberflip.com/i/540712
Soc ial Sec urity or CC Student ID Name: Last First M.I. Address: Street City State Zip County I av e liv ed at th is address or at least th ree month s. Date of Birth I am ov er th e ag e of 16 . Gender: Cell or ome Ph one: Work Ph one: E-Mail Address My inf ormation as ang ed sinc e my last reg istration: name address p one email I av e rev iously tak en a lass at CC. I am a Mary land resident ag e and older and ualif or a tuition aiv er. Not ap lic ab le to E ourses or ees. COURSE NUMBER Title Tuition XE-800 9783 #3492 SAMPLE Personal Landsc ap ing SAMPLE Out-of -c ounty Mary land residents add 10 er ourse. Residents outside Mary land add er ourse. SENIORS: Mary land residents ag es and older only Pay all ees listed in th e ourse desc rip tion. Exception: For E ourses, ay th e ull amount listed at th e end of th e ourse desc rip tion. Total Signature: ______________________________________________________________ Date: ____________________________ I certify that all of the above information is true and correct. ✃ Noncredit Registration Form PLEASE PRINT NEATLY Please note th at e do not ac ep t reg istrations email. Th is orm ill not e roc essed if sub mitted email. Online: isit hccexpress.net. Fax-in: Fax th is orm redit ard inf o. to: -5 18 -4 . Allow day s or roc essing . Walk-in: Bring orm and ay ment to the Registration Office, Student Serv ic es Bldg . ours: a.m.- .m. Monday th roug Th ursday a.m.- .m. Friday . Mail-in: Send reg istration orm and redit ard inf ormation or ec to: Howard Community College, 10901 Little Patuxent Pkwy, Columbia, MD 21044- 3197, ATTN: Lock Box Cashier, RCF-203. Inc lude address, ome and usiness ones on ec . Allow 1 eek to roc ess. FOR FAX-IN OR MAIL-IN: Visa, MasterCard, American Express, Discover (circle one) Card Ex . Date Cardh older' s Name Please print legibly Sig nature Are ou of isp anic or Latino orig in? es_ No_ Wh at is our rac e? Selec t one or more of th e ollow ing ateg ories: ___American Indian or Alaska Native ___Native Hawaiian or Other Pacific Islander Asian Wh ite Blac or Af ric an Americ an For race definitions, visit www.howardcc.edu/visitors/Webmaster/race_ethnicity.html Students o reg ister mail or ax ill rec eiv e an email reg istration confirmation (printed confirmations will no longer be mailed). I do not want to receive registration confirmation emails. Male Female