Non-Matriculated Student Registration Form - Cambridge College Forn
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1Non-Matriculated Student
Student ID# ________________________
Registration Form
Your Cambridge College Location
Registrar's Office
Cambridge
Puerto Rico
1000 Massachusetts Avenue
For students not in a degree or certificate program
Lawrence
Southern California
Cambridge, MA 02138
Springfield
Phone: 617.873.0101
Fax: 617.349.3560
Term
Fall
Spring
Summer
Year:
Student Information
Last name _________________________________________
First name _________________________________
Middle name _________________________
Current Residence:
cell
(________) _____________________
Address ______________________________________________________ Apt _____________ Phone
home
(________) _____________________
City ______________________________ State ________ Zip ____________________________ Work Phone / ext.
E-mail
home
work _______________________________________________________________________________________________________________
Social Security number ____________________________________
Date of birth: Month ____________
Day ___________
Year ______________
Courses
Course #
Section
example: WRT101
example: CA01
Course Title
Instructor
Credits
Registration cannot proceed if there is a HOLD on your account.
Students Not in a Degree or Certificate
Demographic Information
Program—Important
Male
Female
Transgender
Gender:
As a non-matriculated student, I acknowledge that I will not have an
Not Hispanic/Latino
Hispanic/Latino
Are you Hispanic/Latino:
academic advisor assigned. However, it is recommended that I seek
academic advice from the dean, program chair or regional center
Please check off one or more of the following races:
director. Courses may not qualify for state licensure programs.
American Indian or Alaska Native
As a non-matriculated student, I acknowledge that I am allowed to
Asian
take up to nine (9) credits. (Certain exceptions based on program,
Black or African American
alumni status or location may apply.)
Native Hawaiian/Other Pacific Islander
White
Although the courses I complete at Cambridge College as a non-
matriculated student may be evaluated for transfer, I know that each
Country of birth: ___________________________________________________
program accepts only a limited number of transfer credits and that
there is no guarantee that courses taken outside advising and
Country of citizenship : ______________________________________________
matriculation will be transferred into a degree program .
Yes
No
Are you a member of the U.S. Armed Forces?
By signing, I acknowledge
that I have read and understand
the policies above and the implications for my academic goals.
After completing form submit it to:
Student signature
on paper printout ________________________________________________________________
Registrar's Office
Cambridge College
1000 Massachusetts Avenue
Date ____________________________________________________________________________
Cambridge, MA 02138
Or email to:
registrar@cambridgecollege.edu
Or fax to:
617.349.3560
rev. 12/4/14
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