Application Form (NEW STUDENTS ONLY)


If you ARE currently enrolled in high school click here. Do not fill out this form.


Note: Arizona State Law requires all students to provide documentation proving their U.S. residency status.

After you have completed this enrollment form, you MUST also complete a U.S. Residency Verification Form at any NPC campus/center location. Students outside the NPC service area should read the acceptable documents list and FAX their documentation to (928) 524-7461  – OR –  email a copy of the appropriate documentation to the NPC Records & Registration Office. Be sure to include your name and contact phone number on the fax or in the e-mail.

  • Questions? Please call the NPC Records & Registration Office at (800) 266-7845, ext.7459.

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NEW STUDENT INFORMATION

Welcome! If you have NEVER attended Northland Pioneer College, please provide us with the following information. If you have attended (perhaps as a dual enrollment or NAVIT or NATIVE student), please call the Records & Registration Office (800) 266-7845, ext. 7459 to confirm your student contact information.

is required for financial aid and tax credit reporting. This number will NOT be used as your student ID and NPC will never publish/sell your social security number.

xxx-xx-xxxx

(Approval process is required for applicants under the age of 14 and certain course requirements for applicants under the age of 18.)

Jr., Sr., III

Ex. maiden name

NPC will NOT give or sell your email addresses to anyone. We will only send you important enrollment information. NPC will provide you with an official student email account.

Street or PO Box

Please use 2-letter postal abbreviation
+4 if known

Do NOT enter a cell phone number here, use entry below.

With Area Code xxx-xxx-xxxx
With Area Code xxx-xxx-xxxx

- only if you would like to be reached at work.

With Area Code xxx-xxx-xxxx
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