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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?
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."
Date of Birth:*
Please note, students must be 14 and older to register for the course. Students aged 14-17 will be required to have parental approval.
What is your age range?*
What campus are you attending?
What term do you intend to register?*
Are you an NWCCD employee or a family member that qualifies for the Tuition Grant?

To qualify for the NWCCD Employee Tuition Grant, you still must complete the form from Financial Aid with all necessary approvals.  The discount will not be immediately applied until the paperwork is completed.

Course Registration Information

To review the class schedule, visit Community Classes.

Taking this class will result in a transcript. You will receive a grade (pass/fail, satisfactory/unsatisfactory, or a letter grade depending on the class). To declare this class as an audit, you will have 21 days from the start of class. If this is your request, please speak with your instructor.

Course Registration*
Course information. EXAMPLE: PEAC 1000 01, Fitness: Cycling, TTH 9 AM to 10 AM.

Certification of Information

*I CERTIFY the information on the application 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for admission, shall have admission and registration cancelled without refund of any fees, the total credits rescinded which have been earned following admission and future registration within the district prohibited.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
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.

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, genetic  information 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 or in person with 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 303-844-341

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

Enrollment Services Processing

Don't forget to enter ALLRG in PERC.

Don't forget to run AGRB to assign financial agreement.

Don't forget to enter Directory Information.


Parental signed form required prior to registration.

7 Digit format for linking (0000000)
You may need to review the application in case the residency has changed since the student last attended. (ASUM)
The indication
Enrollment Services Date*

Business Office Review:

Eligible for Golden Age Grant.

Business Office Date:*

Final Enrollment Services Conversation

How many courses:*
Enrollment Services Date:*