Course Registration Form Please fill out this form and an Academic Counselor will contact you to assist with your registration process. Contact from the Counselor will be via e-mail unless you do not have an email address. NOTE: If you have questions about registering for online courses you must contact a counselor instead of submitting this form. General InformationName* First Last Student ID*You receive your Student ID after you apply to NIACC. If you do not know your Student ID, please call: 641-422-4245 or 1-888-GO NIACC (466-4222) ext. 4245Last four digits of your Social Security Number*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* If you do not have an email, enter NA and provide a phone number where you can be reached.Phone*If you do not have a phone number, enter NA and provide an email address where you can be reachedRegistration InformationAre you a previous NIACC student?*YesNoAre you currently attending another college?*YesNoAre you seeking a degree at NIACC?*YesNoWhat degree are you seeking?*What term are you registering for classes?*Fall SemesterHoliday Break Courses (December-January)Spring SemesterSummer (May) - May 15 - June 9, 2017 (4 weeks)Summer (June) - June 12 - July 21, 2017 (6 weeks)Notice The spring tuition bill is due before classes start. One of the following needs to be in place: Spring bill paid in full. Financial aid arranged to cover the bill. A payment and a payment plan arranged with the business office for a payment schedule for the spring semester Failure to make one of the above arrangements by the fourth week of the semester may result in your withdrawal from the spring classes.Notice The summer tuition bill is due before classes start. One of the following needs to be in place: Summer bill paid in full. Financial aid arranged to cover the bill. A payment and a payment plan arranged with the business office for a payment schedule for the summer semester Choosing Your Course(s)Please enter the course(s) that you are registering for. If you do not know the course number, please read "Search for Sections Instructions". When you find the course you want to register for, enter the "Section Name and Title" for the course(s) in the fields provided below. Course 1: Section Title*Here are examples of accepted section titles: ACC-111-0001 HSC-171-0006 Course 1: Section Name*Example: Intro to AccountingCourse 2 Add Course 2 Course 2: Section Title*Here are examples of accepted section titles: ACC-111-0001 HSC-171-0006 Course 2: Section Name*Example: Intro to AccountingCourse 3 Add Course 3 Course 3: Section Title*Here are examples of accepted section titles: ACC-111-0001 HSC-171-0006 Course 3: Section Name*Example: Intro to AccountingCourse 4 Add Course 4 Course 4: Section Title*Here are examples of accepted section titles: ACC-111-0001 HSC-171-0006 Course 4: Section Name*Example: Intro to AccountingCourse 5 Add Course 5 Course 5: Section Title*Here are examples of accepted section titles: ACC-111-0001 HSC-171-0006 Course 5: Section Name*Example: Intro to AccountingCourse 6 Add Course 6 Course 6: Section Title*Here are examples of accepted section titles: ACC-111-0001 HSC-171-0006 Course 6: Section Name*Example: Intro to Accounting Corresponding Nurse Course You will also be registered for the equivalent Nurse Aide Clinical Course Corresponding Nurse Course You will also be registered for the equivalent Nurse Aide Theory Course If you have any additional information about registering for online courses, please provide them here.Terms and Agreement for Registering for Online CoursesI promise to pay North Iowa Area Community College for tuition and fee charges and housing (if applicable) for each semester I enroll. Should I choose not to attend or am unable to attend, I will notify the NIACC RECORDS OFFICE in WRITING prior to the term start date. I understand that I will be held liable for tuition and fee charges and housing (if applicable) should I fail to notify the Records Office in writing prior to the term start date. Terms and Agreement for Registering for Online Courses By checking this box, I agree to the "Terms and Agreement for Registering for Online Courses" When registration is complete, you may log into your MyNIACC account to view and/or pay your bill by credit card. You may mail payment to the NIACC Business Office, 500 College Drive, Mason City, IA 50401. If you need help logging into your MyNIACC account, please contact the Help Desk at 1-866-614-5020, or (641) 422-4357, or by email at helpdesk@niacc.edu. NameThis field is for validation purposes and should be left unchanged.
