Spring Enrollment Form

North Central Kansas Technical College

Spring Online Education - Application and Enrollment Form


The North Central Kansas Technical College does not discriminate on the basis of sex, race, color, religion, national origin, age, handicap or marital status in admission or access to, or treatment of, or employment in its programs and activities. If you have questions regarding the below, please contact the NCKTC Dean of Student Services (1.800.658.4655).


Admission Requirements:
The information furnished to the college will not be used to deny admission, but is needed for reporting purposes. High School graduates, or those who hold a High School Equivalency Diploma, are admitted without reservation after having the following on file with the Registrar's Office:

1. Pay a $50 non-refundable application fee.

3. When applicable, a transcript from prior colleges.




1. Please complete all questions as completely and accurately as possible.
2. Submit this form.
3. Pay a $100.00 non-refundable deposit per course that is due upon enrollment.

4. Full payment of the remaining tuition is due within the first 10 days of the start of the course for any portion not covered by financial aid. Non-payment within the 10 day period will result in removal from the course/courses enrolled. Tuition is set at $132.00 per credit hour. Additional lab fees are incurred for science courses.






* Indicates the question is required to submit the form.


Step 1: Please complete all questions as completely and accurately as possible


*Today's date
*Last name
*First name
*Middle name
Maiden name
*Email address
NOTE: Your E-mail address must be accurate as you will receive confirmation at this address.
*Home Phone
*Cell Phone
*Street address
*Zip/Postal code
*Social Security #
*Date of Birth
Are you a US Citizen?
Are you a Kansas Resident?
Are you active-duty military?
Are you a military dependent?
Are you a Veteran?
Do you have a driver's license?
*Are you a current high school student?
High School Last Attended
City State
Graduate?    Year of Graduation 
If you did NOT graduate from high school, do you have a GED?    Year Obtained
           Associate Degree College State: Year:
            Bachelor Degree College State: Year:
            Masters Degree College State: Year:
         Doctorate Degree College State: Year:
       Current or Last Enrollment State: Year:
                          Ethnic Group
*Is this your first On-line Course?  
Are you a first-time college student?
Have you previously
attended NCKTC
If Yes, dates attended (Yr.)
Are you transferring from another college?
Do you plan to earn a degree from NCKTC?
Will you transfer after receiving your degree?
              Father's Education Level
             Mother's Education Level
*Payment Method


Courses with less than the minimum number of students registered and paid by January 9th will NOT be held! Minimum number varies by class.
Spring 2015 Classes Begin January 19, 2015 unless otherwise noted!
Book Purchases Required BEFORE Classes Begin!
Enrollment will NOT be finalized until deposit is received!! Class sizes are limited.
Pay TODAY to reserve your seat!!
Deadline for all class enrollment and deposit payment is January 9, 2015.

Course Title Cr Hours Instructor
 BIOL 225 *Microbiology (additional $100 lab fee) 5 Hrs J. Klann
 BIOL 230 *Anatomy and Physiology (additional $100 lab fee) 5 Hrs J. Klann
 BMGT 108 Business Management 3 Hrs D. Offutt
 CIS 108 Advanced Computer Applications 3 Hrs J. Moeller
 COM 103 *English Composition I 3 Hrs C. Bertuccelli
 COM 105 Oral Communications (Speech) 3 Hrs B. Leiker
 COM 210 Medical Terminology 3 Hrs B. Dechant
 HE 230 Principles of Nutrition 3 Hrs J. Verdugo
 MA 110 *Intermediate Algebra 3 Hrs M. Pahls
 MA 111 *College Algebra 3 Hrs M. Pahls
  MA 200 *Elementary Statistics 3 Hrs M. Pahls
 SOC 135 Sociology 3 Hrs J. Tice
 SS 100 General Psychology 3 Hrs J. Tice
 SS 105 Human Growth and Development 3 Hrs R. Meyers
 MA 200 Elementary Statistics 3 Hrs M. Pahls
*Prerequisite Required - Please see course list for additional information at http://www.ncktc.edu/Online/courses.htm

Please review the information above and make sure that the information is accurate and up-to-date.

Enrollment will NOT be finalized until payment is received!!
Deadline for all class enrollment and deposit payment is January 9, 2015.

Book purchases are required BEFORE classes begin!!!

Step 2: Submit this application


Step 3: Pay Online Tuition with PayPal

Online Tuition per Credit Hour

Once this information is submitted it will take at least two business days to process. Please contact the Cashier (1.800.658.4655 ext.003) with payment information as your enrollment will be held until full payment is received.  Online Tuition and fees are non-refundable. You will receive an email acknowledging your completion of the form, full payment and your inclusion into the classes you have selected.


If you are not enrolled into the selected classes you will be notified and further information about when and if you will be able to take the classes will be emailed within two business days of your completion of the form.