Noncredit Course Registration Request Form

Noncredit Course Registration Request Form
Thank you for your interest in our Continuing Education programs. Please note:
- Registration requests submitted through this form will be processed 8 a.m. to 4 p.m., Monday through Friday, except during campus closures and holidays.
- This form can only be used to register the individual whose information is listed below. This form must be submitted by the individual listed below, or by their parent/guardian, significant other, or sponsoring employer.
- Submitting this form authorizes our office to register and bill the individual listed on this form for the specified noncredit course(s). If additional information is needed for us to register you for a course, or if a class you’d like to sign up for is no longer accepting registrations, we will contact you as soon as possible.
- For our course drop, refund and tuition liability policy, please see this page.
Student's Legal Name*

Legal First NameMiddle NameLast Name
Chosen first name, if different than above (If you want to use a name other than your legal name to identify yourself, SUNY Adirondack has a process to allow students to request use of a chosen first name where possible. Please contact our office for additional information.)
Birth Date*

MonthDayYear
Banner ID
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email Address*
Home or Cell Phone Number*

Area CodePhone Number
Work Phone (optional)

Area CodePhone Number

Please list the course(s) for which you would like to register.

Please note that you will automatically be billed for these course(s) once your registration has been processed by Continuing Education staff. If a course is unable to take registrations, or if additional information is needed to process your registration, Continuing Education staff will contact you by phone or email as soon as possible.

	Course Title	CRN	Course Start Date

Do you have a Learning Certificate to pay for this course? If so, please indicate the certificate number here.
Are you registering for one or more classes that will be held in person at a SUNY Adirondack campus location (the Queensbury campus, SUNY Adirondack Saratoga in Wilton, or the Culinary Arts Center)?

YesNo
Additional Comments (if applicable)
Classes are better with a friend! If you know someone who would enjoy learning about our courses, please share their name and email below, and we'd be happy to reach out to them with information about upcoming Continuing Education programs.

What date does your class begin?

MonthDayYear
Date
Please upload a picture of your COVID vaccination record/card.

Browse Files

Cancelof

I have read and understand the attestation above.

Yes, I have read and understand the above information. By clicking Yes here, I am confirming my attestation.

IMPORTANT - Please read the following, then click the "Submit" button below to submit your registration request. Contact the Office of Continuing Education at 518-743-2238 or conted@sunyacc.edu with any questions.
- The information submitted in this form will be used by Continuing Education staff to register the individual listed on this form for the course(s) specified.
- Once you have been officially signed up for the class in the College’s registration system, Continuing Education staff will send you a confirmation by email or phone, as well as send a hard copy of the confirmation and bill to your mailing address.
- If a course is full and unable to take additional registrations, or if we need to clarify additional details to finalize your registration, we will contact you by phone and/or email as soon as possible.
- Please note that you will be automatically billed via mail for the course(s) once your registration has occurred. Details on our refund/bill adjustment policy and how to pay course fees are available at https://www.sunyacc.edu/programs-courses/continuing-education/continuing-education-registration-information.
By clicking the submission button below, I confirm that I am the individual listed on this form, or their parent/guardian, or their significant other, or a sponsoring employer.
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