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Community Interest Class Application & Registration Form

Please provide answers to the following questions:

Applicant Information

Legal Name:*
Mailing Address:*
May we text message you at this phone number?
Type:*
Are you a US Citizen?*
Residency is at least a minimum of six (6) months.
How long have you lived in this residency state?*
Please note, additional documentation may be required.

As a permanent resident, we are required to receive a copy of your identification card.  Please stop by our Enrollment Services Office in the Whitney Building to provide this documentation. 

If you decline to provide this information, please enter "declined."
Gender:*
Date of Birth:*
Ethnicity*
Race:*
What campus are you attending?
What term do you intend to register?*

Course Registration Information

To review the class schedule, visit Community Classes.

Provide as much known course information. EXAMPLE: PEAC 1000 01, Fitness: Cycling, TTH 9 AM to 10 AM.
Do you want college credit for this course (#1)?
Provide as much known course information. EXAMPLE: PEAC 1000 01, Fitness: Cycling, TTH 9 AM to 10 AM.
Do you want college credit for this course (#2)?
Provide as much known course information. EXAMPLE: PEAC 1000 01, Fitness: Cycling, TTH 9 AM to 10 AM.
Do you want college credit for this course (#3)?

Certification of Information

*I CERTIFY the information on the applcation is accurate.*
PLEASE NOTE: Any applicant who gains admission on the basis of incomplete or fraudulent credentials or misrepresentation in the written application for admission, shall have admission and registration cancelled without refund of any fees, the total credits rescinded which have been earned following admission and future registration within the district prohibited.
*I GIVE MY PERMISSION to release directory information which includes name, address, e-mail, telephone number, campus, program of study, dates of attendance, degrees and awards, date and place of birth, previous schools attended, participation in officially recognized sports and activities, and weight and height of members of athletic teams.***
“No” for Release of Information means information pertaining to you will not be acknowledged, published, or released to anyone who is not affiliated with the college. (Policy 5035.1) A Student Directory is not published. Student information is not sold or given to businesses for private use.
I authorize the college to collect and share, at a minimum, my personal identifying information, collected through the college’s admissions application, the FAFSA, enrollment information, and all other information necessary to determine my eligibility for state financial aid or general state reporting with.*
*BY ENROLLING IN courses at NWCCD, I understand that I am academically and financially responsible for all courses. I agree to be bound by all terms of the student financial agreement as presented with my application for enrollment at NWCCD which states that payment of all charges to my student account are my responsibility. *
Full Student agreement can be viewed online at https://www.sheridan.edu/services/terms/.
Date Submitted:*

The electronic signature consists simply of your name, typed by you on your keyboard. The signature is your confirmation that the application you have filled out is your own work and the information is factually true. Once you type in your name and the date, this will count as your electronic signature. You certify that you have read the terms and conditions of the Student Financial Responsibility Statement, located here, and agree to abide by and bound by those terms and conditions.


The Northern Wyoming Community College District will follow State and local recommendations regarding gatherings of any kind during the COVID-19 pandemic response. Therefore, events may be altered, postponed, or canceled with little notice at the District’s discretion due to this rapidly changing environment. We appreciate your patience and understanding. For up-to-date information on current restrictions, please visit https://www.ccgov.net/2104/Coronavirus-COVID-19

Northern Wyoming Community College District prohibits discrimination in employment, educational programs and activities on the basis of race, national origin, color, creed, religion, sex, pregnancy, age, disability, veteran status, sexual orientation, gender identity, or any other class protected under state and federal law. The District also affirms its commitment to providing equal opportunities and equal access to its facilities. Inquiries concerning Title VI, Title VII, Title IX, Section 504, and the Americans with Disabilities Act may be referred to the Assistant Vice President for Human Resources, Jennifer McArthur, NWCCD’s Title IX and Section 504 Coordinator, Sheridan College, Griffith Memorial Building, Room 141D, 1 Whitney Way, Sheridan, WY 82801; 307-675-0505. Inquiries also may be made to the Office for Civil Rights, U.S. Department of Education, Federal Building, Suite 310, 1244 Speer Boulevard, Denver, CO 80204-3582; 303-844-3417; or TDD 303-844-3417. NWCCD is committed to maintaining a safe and secure campus environment.

As a part of ongoing safety efforts, NWCCD publishes an annual report that discloses crime statistics on and around our campuses. A direct link to the most recent Annual Security and Fire Safety Report is provided here. If you wish to obtain a hard copy of this report, please contact the Office of Risk Management at 307-675-0812 or by emailing jclements@sheridan.edu.

Admissions Processing

7 Digit format for linking (0000000)
Admission Processed Date*

Enrollment Services Processing

Don't forget to enter ALLRG in PERC.

Eligible for Golden Age Grant?*
Enrollment Services Date*

Business Office Review:

Business Office Date:*

Final Enrollment Services Conversation

How many courses:*
Enrollment Services Date:*