C9 Enrollment NHJ 2020-2021 School Year
If a program is not listed, it is currently so full with requests that we will be using a waiting list. Please stop by our Student Services office to be placed onto a waitlist. You should pick your next option as your 1st choice.
The questions with a red * must be completed, questions without an * should be answered if you know the information!
Email address *
STN Number
Your answer
Student Last Name *
Your answer
Student First Name *
Your answer
Student Middle Initial *
Your answer
Gender *
Your answer
Grad Year *
Birthdate *
MM
/
DD
/
YYYY
Social Security Number
Your answer
Do you attend ICLC *
Program Choice 1 *
Program Choice 2 *
Program Choice 3 *
Street Number *
Your answer
Street Direction
Your answer
Street Name *
Your answer
Apartment Number
Your answer
PO Box
Your answer
City *
Your answer
State
Zip
Your answer
County of Residence
Student Cell Number
Your answer
Guardian 1: First Name *
Your answer
Guardian 1: Last Name *
Your answer
Guardian 1: Phone Number
Your answer
Guardian 1: Email
Your answer
Guardian relationship to student *
Your answer
Guardian 2 First Name
Your answer
Guardian 2: Last Name
Your answer
Guardian 2: Phone Number
Your answer
Guardian 2: Email
Your answer
Guardian 2: Relationship to student
Your answer
Does Guardian 2 live at the same residence as student?
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