Registration Form

Contact Information











Participant Personally-Identifiable Data Collection Notification

The collection of this information helps to track the long-term success of this training program. Your personal information is encrypted and will be kept confidential. It will not be shared with any outside agencies other than those involved with the support or oversight of the funding grant received by Monroe Community College. Your information will never be sold or shared with third party agencies through your participation in grant supported training activities. 

In addition to requesting a range of information from project participants, including demographic information, the use of your Social Security Number is also requested in order to access wage and employment information through state data bases. Although you cannot be denied service for failure to provide your Social Security Number, we strongly encourage you to do so in order to enable the project to quantify specific employment-related outcomes. Your personal information will be kept confidential.


Please use the following date format. mm/dd/yyyy

Address Information




Demographic Information
The NYS Education Department and the United States Office of Education requires all colleges to report minority student enrollments. The information collected will assist in meeting this requirement. Check the appropriate spaces as they apply to you.




Educational Information


Americans with Disabilities Act Infromation 

Monroe Community College is committed to upholding and maintaining all aspects of the Americans with Disabilities Act Amendment Act (ADAAA) and Section 504 of the Rehabilitation Act. If you are a student with a disability and wish to request accommodations, please contact the Office of Disability Services located in Building 3, Room 103 to schedule an appointment (585-292-2140) on the Brighton Campus or on the 3rd floor – Room 310 on the Downtown Campus. Please note that many accommodations require early planning; therefore, requests should be made as early as possible.

Course Registration Section

(example - WBUS407)

(example - 48505)

(example - The Medical Interpreter)
Additional Registration Information
Registration for certain courses may require a pre-approval from the Program Director before being officially registered for a course. In the case one of the selected courses above requires pre-approval, the Program Director will reach out to you directly. Official registration into the course is on a first come, first serve basis. 
Signature
I acknowledge that my tuition will be paid by the tuition due date and further acknowledge that I am liable for any collection costs incurred by the College as a result of my failure to pay including, without limitation, collection agency fees, court costs and attorney’s fees. If I decide to change my educational plans, I will notify the Office of Registration and Records in writing and realize that non-attendance in class will not relieve me of my financial responsibility.


Contact Information