Tompkins Cortland Community College Registration Form

Submit this form by mail to Tompkins Cortland Community College, Enrollment Services Center, P.O. Box 139, 170 North Street, Dryden, NY 13053-0139. You can also submit by fax to 607.844.6541 or in person at the Dryden, Ithaca, or Cortland campuses. For more information, call 607.844.8222 ext. 4487. Ensure all sections are completed and signed before submission. It is advisable to keep a copy of the completed form for your records.

Important dates for this registration form include the start of the fall, winter, spring, and summer semesters in 2024 and 2025. Ensure to check the academic calendar for specific deadlines.

The purpose of this registration form is to collect essential information from students enrolling at Tompkins Cortland Community College. It helps the college manage student data, course registrations, and compliance with state and federal requirements. Additionally, the form serves as a communication tool between students and the college administration regarding educational goals and special needs.

• 1. Name: The full legal name of the student.
• 2. Permanent Address: The main residential address of the student.
• 3. Local Address: The local residential address of the student if different from the permanent address.
• 4. Student ID Number: A unique identifier assigned to each student by the college.
• 5. Social Security Number: The student's Social Security Number.
• 6. Phone: The contact phone numbers of the student.
• 7. Email: The student's primary email address.
• 8. Emergency Contact: Name and phone number of the person to contact in case of an emergency.
• 9. Birth Date: The student's date of birth.
• 10. Gender: The student's gender identification.
• 11. Military Service Status: The student's military service status, if applicable.
• 12. Citizenship Information: The student's citizenship status and country of citizenship.
• 13. Ethnicity: The student's ethnic background.
• 14. Hispanic/Latino: Indicates if the student is of Hispanic or Latino origin.
• 15. High School Graduation: Information about the student's high school graduation status.
• 16. GED: Indicates if the student has received a GED certificate.
• 17. Educational Goal: The student's goal for attending the college.
• 18. Previous College Attendance: Information about the student's previous college attendance.
• 19. Degree Received: Indicates if the student has previously received a degree and its level.
• 20. Course Registration: Details about the courses the student wishes to enroll in.
• 21. Student Agreement: The student's agreement to abide by college policies and procedures.
• 22. Immunization Requirement: Proof of MMR immunization required for students born on or after January 1, 1957.

Failure to submit this form may result in inability to enroll in courses or access college resources. It may also delay your academic progress and affect financial aid eligibility.

• Enrollment Issues: You may not be able to enroll in desired courses.
• Resource Access: You may lose access to college resources and facilities.
• Academic Progress: Your academic progress may be delayed.
• Financial Aid: Your eligibility for financial aid may be affected.

• 1. New Enrollment: Complete this form when enrolling as a new student.
• 2. Course Updates: Use this form to update your course selections each semester.
• 3. Information Updates: Submit this form to update your personal or contact information.
• 4. Military Status: Provide or update your military service status using this form.
• 5. Financial Aid: Use this form when applying for financial aid and providing your educational background.