Complete all information and print clearly. Student data on this form is CONFIDENTIAL. Anything marked with an (*) is required for form completion. All other information is optional.
***Required for Fire/EMS/DPS/ Law Enforcement My signature attests that I am actively affiliated with the public safety agency listed and that I hold the job classification indicated.
Additional provisions of the refund policy, including those regarding self-support classes and student fees are available upon request.
My digital signature below authorizes that registration fees will be paid before the initial start of class.
Pamlico Community College is an Equal Opportunity Educational Institution and does not discriminate in its educational programs, activities or employment on the basis of gender, age, disability, race, color, national origin, orientation or religion.