North Central Kansas Technical College
Fall Online Education - Enrollment Form

Directions:

1. Please complete all questions as completely and accurately as possible
2. Submit this application. Starting July 1, 2010 a $50 application fee will be added to your enrollment charges.
3. Pay a $101.50 per credit hour enrollment fee that must be paid before enrollment can be completed.  Deadline for all class enrollment and payment is August 20, 2010.

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).

GENERAL ENROLLMENT INFORMATION:

* Indicates the question is required to submit the form.

Step 1: Please complete all questions as completely and accurately as possible
Semester  
*Today's date
*Last name
*First name
Middle Initial
*Email address
Note: Your E-mail address must be accurate as you will receive confirmation at this address.
*Telephone Number
* Cell Phone Number
*Address
*City
*State
*Zip
 
* Is this your first On-line Course?:
Have you previously attended NCKTC?:
If Yes, dates attended: (Yr.)
*  Payment Method?
NCKTC FALL 2010 ONLINE COURSES

Fall 2010 Classes Begin August 30, 2010 unless otherwise noted!
Book Purchases Required BEFORE Classes Begin!
Enrollment will NOT be finalized until payment is received!! Class sizes are limited.

Courses with less than four students registered and paid by August 20th will NOT be held!
Pay TODAY to reserve your seat!!
Deadline for all class enrollment and payment is August 20, 2010.
Course Title Cr Hours Instructor
BMGT 108 Business Management 3 Hrs TBA
COM 103  English Composition I 3 Hrs TBA
CIS-108 Advanced Computer Applications  - enrollment closed for Fall 3 Hrs TBA
HE 230  Principles of Nutrition 3Hrs Verdugo
SOC 135  Sociology 3Hrs C. Witt
 PHRM 101 Orientation to Pharmacy Practice- enrollment closed for Fall 3 Hrs  Dechant
COM 210 Medical Terminology 3 Hr Dechant
SS 100  General Psychology 3 Hrs Mennenga
MA-111 College Algebra -  enrollment closed for Fall 3 Hr TBA
SS 105  Human Growth and Development 3 Hrs Mennenga
HS-100  Rehabilitative Aide (November 8 - December 17) 1 Hrs D. Offutt
WL 100 Introduction to Blueprint Reading- enrollment closed for Fall 1 Hr TBA
OSHA 110 OSHA 10 hr Certificate 1 Hr Online
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 payment is August 20, 2010.

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. 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.