Online Registration for Internet Classes

Fall 2008
Online Web Registration/Enrollment
for Internet Courses

Internet courses are really just another modality for the presentation of knowledge, and are treated the same as any other course for student enrollment. Students are also expected to complete all coursework within the actual semester.

Students can freely enroll in an Internet course up to one week after the first day of classes (by January 21, 2008), if the class is not at maximum capacity. After the first week of class, instructor approval is required before a student can be enrolled in the Internet course. The exception is "open entry/open exit" courses – ECD 233 & POS 221, and 222.

Your browser must be configured to send email to use this form.

ADDITIONAL REGISTRATION OPTION: Students may register and pay for Internet classes via telephone, as long as class prerequisites have been met. For telephone registration, please call the Records and Registration Office at (928) 524-7660 or (800) 266-7845, ext. 7660.

You can also contact the Internet Registration Clerk via email, intreg@npc.edu

Before filling out this form, you can view a list of Internet classes, selecting the semester you plan to attend. Then click your browser's Back Button to return to this form. Please answer all questions relevant to your registration status.

Attention POS 221 and POS 222 students: If you are taking one or both of these courses for Arizona Teacher Certification please click here to see if you meet In-State Tuition requirements. If you do not qualify for in-state status, but meet the requirements of the Arizona statute, you must complete section 19 in this form to request in-state tuition.

If you use this form to register for Internet courses, payment or payment arrangements must be made within two (2) business days after email notification has been sent by NPC or you will be dropped from class(es).

Payment Options

Online payment is available through eCashier.
If you are paying with a VISA or MasterCard, call the Business Office (928) 524-7680 or (800) 266-7845, ext. 7680.
If you prefer to pay by another method, you must go to an NPC campus or center office.

Payment or payment arrangements must be made within two (2) business days after email notification has been sent by NPC or you will be dropped from class(es).

SPECIAL NOTE: Students may be charged a fee for use of electronic textbook materials. This fee will be charged upon initial login to the Internet course. If you need additional information, contact your instructor.

NOTE: To move from one text box to the next when entering data, use TAB or arrow key, or use your mouse to select a data field.

Note: If you have not received a response from NPC within five (5) business days, an electronic glitch may have occurred in your online form submission. Please call the Records & Registration Office (928) 524-7660 or (800) 266-7845, ext. 7660.

Online Internet Course Registration Form

1. Last Name: (Required)

2. First Name: (Required)

3. Middle Name:

4. Name Suffix (Sr., Jr., etc.):

5. Date of Birth: (mm/dd/yyyy) Needed for tuition calculation.

6. Mailing Address: (Required)

A. Street or PO Box:

B. City:

C. State: (Please use 2-letter code)

D. ZIP Code:

7. Daytime Telephone Number:

8. Email Address: (Required)

9. Have you ever been admitted to Northland Pioneer College?

Yes No

The requested information in questions 10 to 12 is voluntary.

10. What is your gender?

Male Female

11. What is your predominant race/ethnic background?

American Indian or Alaskan
White (Caucasian)
Black
Asian or Pacific Islander
Hispanic
Other

12. Do you have a disability?

No.
Yes. (If you require assistance or accommodations to participate fully as a student, please contact the Disability Resources and Access Office at (928) 532-6178 or (800) 266-7845, ext. 6178 [TDD Service (telecommunications for the deaf) ONLY (928) 537-2030 or (800) 615-6764] or by email to sandy.manor@npc.edu.) Your browser must be configured to send email.

13. What is your U.S. residency status? (You must select one status.)

A. United States Citizen (Please enter information in one of the five following options.)
- 1. Arizona Driver's License (issued AFTER August 1, 1996).
  Enter a valid Arizona Driver's License Number:
  
  2. U.S. Birth Certificate. Date Certificate was issued: (mm/dd/yyyy)
  
  3. U.S. Passport (unless stamped "Non-Citizen National") Document Number:
  
  4. I-9 process completed by employer. (Provide signed letter on company letterhead, if available, from employer indicating student has undergone the I-9 employment process and the student's U.S. residency status [fax to 928-524-7661] (NOTE: Student's U.S. residency status will be out-of-state until letter received.)
  
  5. FAFSA submitted and legal U.S. residency confirmed. (NOTE: Student's U.S. residency status will be out-of-state until letter received.) Year submitted:
B. Legal Immigrant/Permanent Resident
- Date of Issue: (mm/dd/yyyy)
  
  Alien Registration Number:
  
  Expiration Date, if any: (mm/dd/yyyy)
C. Lawful Refugee or Asylee
- Date of Issue: (mm/dd/yyyy)
  
  Alien Registration Number:
  
  Expiration Date, if any: (mm/dd/yyyy)
D. Legal Non-Immigrant
- Specify Immigration Classification:
  
  Alien Registration Number or I-94 Number:
  
  Date of Issue: (mm/dd/yyyy)
  
  Expiration Date, if any: (mm/dd/yyyy)
E. Do Not Qualify for Any of the Above
- Country of Citizenship:
If you are an international student wanting a Form I-20, STOP! Contact the Admissions Office for International Applications at (928) 536-6271 or (800) 266-7845, ext. 6271 or by email. (Your browser must be configured to send email.)

14. What is your admission status? (Please check all that apply.)

A. Previously attended another college.

B. High school graduate.
- B1. Name of high school:
  
  B2. State: (Please use 2-letter code)
  
  B3. High school graduation Date: (mm/dd/yyyy)
C. GED Certificate
- C1. Year GED Received: (mm/dd/yyyy)
  
  C2. Which state granted GED: (Please use 2-letter code)
D. I am currently enrolled in high school.
- D1. Name of high school:
  
  D2. Expected graduation date: (mm/dd/yyyy)
E. I am over 18 and do not qualify under any of the categories listed above.

15. What is the date your stay began in Arizona? (mm/dd/yyyy)

16. If Arizona resident, list county of residence

17. If you have not lived in Arizona continuously for 12 months, in what state are you a resident? (Please use 2-letter code)

18. Primary Purpose for Attending NPC:

19. POS 221 or 222 Special Request for In-State Tuition Rates:

I am requesting special in-state tuition rates based on Arizona Revised Statute (ARS) § 15-1802 and am employed by the School District.

20. Please select the NPC Internet Courses in which you want to register.

Classes shown are Open Entry-you can register anytime during the semester.

CIS 199 Software Quality • 3 cr. (Open Entry-Exit)
CIS 199 Engineering Quality in Software Development • 3 cr. (Open Entry-Exit)
CIS 199 Software Testing • 3 cr. (Open Entry-Exit)
POS 221 Arizona Constitution and Government • 1 cr.
POS 222 United States Constitution • 1 cr.

SBM 150 Building a Winning Business • 1 cr.
SBM 152 Small Business Management Accounting • 2 cr.
SBM 154 Marketing: From Product to Profit • 1 cr.
SBM 156 Small Business Legal Issues and Insurance • 1 cr.
SBM 160 Managing the Company Budget • 1 cr.
SBM 162 How to Write a Business Plan • 1 cr.
SBM 164 How to Write a Marketing Plan • 1 cr.
SBM 166 Small Business Finance • 1 cr.
SBM 199 Tax Strategies for Small Business • 1 cr.
SBM 199 Small Business Training • 3 cr.

Scroll through the form and make sure you have responded to all questions and selected the appropriate Internet course(s).
Print a copy for your records using your browser's Print function.
Then click on the submit button.

Please note that submission of this form does not guarantee that you will be enrolled in any of the classes.
Note: If you have not received a response from NPC within five (5) business days, an electronic glitch may have occurred in your online form submission. Please call the Records & Registration Office (928) 524-7660 or (800) 266-7845, ext. 7660.

Fall 2008 Online Web Registration/Enrollment for Internet Courses