Mail-in or Fax Registration Form

Year 20
Mail-in or Fax
Registration Form
Please Check Semester:
 Fall
 Summer
1400 Tanyard Road • Sewell, NJ 08080
For use by visiting and part-time students
856-468-5000 •
Soc. Security #
Student ID
Last Name
First Name
Middle Initial
ZIP Code
Type (circle one): Home Business Cell Phone
Preferred Phone (day)
Home College (if visiting student)
Email address
To be completed by Student
Ref #
Ex: Art
– Section
Calculate Cost
Ex: MR
Ex: 8 am
9:15 am
Ex: 3
Total Cost
Instructions for mail-in or fax registration:
1. New students and students who have not attended within the last three years must complete the application for admission found at
2. Mail/fax registration form must be accompanied by payments, fees and any additional prerequisite documentation, including exemptions from basic skills
courses, math, reading and writing. a visiting (non-matriculated) student who attends a two- or four-year institution on a full-time basis and has completed the
necessary prerequisite courses, may be exempt from placement tests during winter/summer semesters. Please supply unofficial transcript from home institution.
3. Fill in registration form completely and sign your name.
4. Calculate the total amount due and send check or money order (no cash please). Make check payable to Rowan College at Gloucester County.
5. For questions regarding payment call: Business Office at 856-415-2226
6. Mail to: Rowan College at Gloucester County, Enrollment Services, 1400 Tanyard Road, Sewell, NJ 08080
7. Fax to: 856-468-8498. To use a credit card, please have cardholder complete the information on the form and mail/fax completed form with
prerequisite documentation.
8. Email: [email protected] or Call Enrollment Services: 856-468-5000, ext. 6471
9. Please note that full-time students and students using financial aid may not use this form.
10. You will receive in the mail a copy of your processed registration form, course schedule and information on how to log-in to the RCGC Portal once
your mail/fax registration has been processed. Please allow one week for processing.
11. Report to the first scheduled class. Please check class dates and locations carefully. RCGC reserves the right to cancel a class if there is insufficient
enrollment, in which event, you will be notified and your tuition will be returned.
If you registered and will not be attending, you must officially drop your classes before the semester begins or you will be held financially responsible.
Refund policy: 100% prior to the start of the semester, 50% during partial refund periods. Please check specific dates and refunds policies,
Credit Card Registration
Please Check One:
 Visa American Express
 M/C Discover
Card #
Expiration Date
Security Code
Cardholder’s Name
Cardholder’s Signature
This form must accompany proper tuition and fees.
Academic advisors are available to assist all students at RCGC and I am choosing to register without the benefit of academic advisement. I will provide
documentation of satisfying prerequisites for the courses I plan to register for. Documentation may include test scores and transcripts. I agree to abide
by the rules and regulations of RCGC as outlined in college publications. I am personally responsible for all costs associated with my course(s), including
tuition and applicable fees. I certify that all information on this form is true, correct and complete to the best of my knowledge.
Registration Form 10/2012
Course input