Deadlines for Fall/Winter/ Yearlong Classes:
·Registration/App: 10.19.25 5:00 p.m. ·Drop Deadline: 11.07.25 5 p.m. ·Withdraw Deadline:12.19.25 Please review OCCC's Student Records (FERPA) Policy here: https://oregoncoast.edu/student-records-and-ferpa/
First Name
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Last Name
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Preferred Name if different
Current Telephone Number
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Email Address
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My current student status is
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I have never taken any OCCC courses. I am brand new to Dual Credit and/or Early College.
I have taken OCCC Dual Credit or Early College courses in the past.
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Application Information
This is the basic information required to complete your entry into our student records system CNS
Current Mailing Address
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City
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State
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Zip Code
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Oregon Resident
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Yes
No
County (ie. Lincoln)
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Country (i.e. US)
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Date of Birth (mm/dd/yyyy)
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Social Security Number
Sex at Birth
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Female
Male
Gender Identity (optional: in terms of gender identity, how do you think of yourself?)
Agender
Identity/Identities Not Listed
Man
Non-binary/Gender Fluid or Non-Conforming
None
Prefer not to say
Questioning or unsure
Trans Man
Trans Woman
Transgender
Woman
Preferred Pronoun
Prefer Not To Answer
He/Him/His
She/Her/Hers
They/Them/Theirs
Zi/Zir/Zim
Zhe/Zhim
Not Listed, Please specify
Please Specify here
Race (Select all that apply)
American Indian or Alaska Native
Asian
White
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
Nonresident Alien
Are you Hispanic or Latino
Yes
No
Are you a first generation student
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Yes
No
Are you a Veteran or dependent of a Disabled Veteran?
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Yes I am a Veteran or Dependent of a Disabled Veteran
Not a Veteran or Dependent of a Veteran
Military Branch / Status
Please Select
Air Force
Air Force Reserve
Air National Guard
Army
Army Reserve
Army National Guard
Coast Guard
Marine Corp
Marine Corp Reserve
Navy
Navy Reserve
Child of Disabled Veteran
Spouse of a Disabled Veteran
I agree to receive text messages
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Yes
No
Please list your carrier
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Registration
Select your high school to display the courses available for you to register
Current Grade Level
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Freshman
Sophomore
Junior
Senior
Current High School
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Newport
Taft
Toledo
Waldport
Siletz
SBCS
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Newport High School
Select the Course (or courses) that you would like to register for
COMM111Z Public Speaking - Rachel Newby (Yearlong)
Early Childhood - Corrina Hargett (Fall/Winter)
ENG104Z Intro to Fiction - Samantha Murphy (Yearlong)
PS201 Government - Ben Ryan (Yearlong)
SPA103 Spanish III - Melissa Wiese (Yearlong)
WR121Z English Composition I- Jake Carlsen (Yearlong)
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Taft High School
Select the Course (or courses) that you would like to register for
BI 101 Biology I FALL - Sara Pursel
BI 102 Biology II WINTER -Sara Pursel
ENG104Z Intro to Fiction - Sunny Adams
CS 160 Exploring Computer Science - Paul Brody
HST201 History - History of the United States to 1840 - Trent Adama
MTH 111Z Pre-Calculus Functions - Eva Ahumada
MTH 251Z Differential Calculus - Noah Lambie
WR121Z Composition I - Sunny Diaz
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Toledo High School
Select the Course (or courses) that you would like to register for
MTH 111Z Pre-Calculus Functions - Mitchell Lampson
PS201 Government - Stephen Curtis
WLD111 Shielded Metal Arc Welding (E7018) and Oxy-acetylene Cutting - Jacob Pearce
WR121Z Composition I - Nathan Bush
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Waldport High School
Select the Course (or courses) that you would like to register for
BI101 Biology I - Alissa Rickborn
MTH 111Z Pre-Calculus Functions - Heather Greel
MTH 251Z Differential Calculus - Heather Greel
WR121Z Composition I - Alexandra Browne
WLD111 Shielded Metal Arc Welding (E7018) and Oxy-acetylene Cutting - Jeff Skirvin
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Siletz Valley High School
Type a question
CG100 College Survivial and Success - Brian Arnold
ENG104Z Intro to Fiction - Trina Kosydar
FES240 - Forest Biology Korey Cimock
MTH 111Z Pre-Calculus Functions - Brian Arnold
WR121Z English Composition I - Trina Kosydar
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SBCS
Type a question
PSY201Z Intro to Psychology - Adam Durkin
CG100 College Survival & Success - Rob Wood
WR121Z Intro to Composition - Jaime Handley
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Consent Statements
I certify that all information provided is true and accurate to the best of my knowledge
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Yes
I consent to and accept all policies and procedures that govern my enrollment. I am responsible for officially withdrawing from any course in which I am enrolled. Failure to do so may result in a failing grade.
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Yes
I acknowledge that as a Dual Credit student, OCCC and my high school will share grades and academic conduct with one another.
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Yes
FERPA Acknowledgement The college abides by and honors all state and federal laws pertaining to the privacy and confidentiality of student directory information and student academic records as outlined in the College Catalog and on the College website. The Family Educational Rights and Privacy Act of 1974 (FERPA) grants students certain rights, privileges, and protections relative to individually identifiable student educational records that are maintained by the college. FERPA allows the College to disclose a student's directory information without consent, unless the College has on file a request from the student to restrict the release of this information.
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I agree
I understand that if I withdraw from a course, I must withdraw from BOTH the High School and OCCC . To withdraw from OCCC go to the Student Forms page https://oregoncoast.edu/student-forms/ and complete the "Request to Withdraw From a Course" form
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Yes
No
By typing your name below, you are electronically signing this document
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