Continuing Education
Non-Credit
Registration

Individuals who wish to enroll in semester hour credit courses must complete an MGCCC Application for Admission.

 

COURSE INFORMATION 

Course Name

Course Date

Scheduled Location

 Jackson County Campus
 Jefferson Davis Campus
 Perkinston Campus
 George County Center
 Advanced Manufacturing & Technology Center
 Keesler Center

 West Harrison Center
 Northrup Grumman badge #
 Online classes

 Other

 

PERSONAL INFORMATION

First Name

Middle Initial

Last Name

Previous Last Name

(optional)

Social Security Number

- - (Required)

Address (Line 1)

Address (Line 2)

City

State

Zipcode

County of Residence

Work Phone

Home Phone

Date of Birth

Ethnic/Racial Group

Ethnicity: Would you describe yourself as a person of Cuban, Mexican,
Puerto Rican, South or Central American or other Spanish culture,
regardless of race?

Yes

No

Gender

 Male
 Female

Are you a high school graduate?

 Yes
 No

Education Level

 less than high school
 high school degree/GED
 some college (no degree)
 associate degree
 bachelor degree
graduate professional degree

 

GED equivalent?

 Yes
 No

Email:

In case of emergency, please call

Emergency Phone

Employment Status

Employed
Retired
Unemployed

Employment Type

Full Time
Part Time
Seasonal
How did you hear about the Continuing Education Program?

Postcard
Continuing Education Brochure
Newspaper / Tabloid Schedule
Friend
Other

Is current/ most recent employment temporary?

 Yes
 No

Name of Employer

The Family Educational Rights and Privacy Act provides for the publication or disclosure of certain directory information on students. Check below if you do not want your name, photograph or other directory information included in these publications.

 

The Family Educational Rights and Privacy Act provides for the publication or disclosure of certain directory information on students. Check if you do not want your name, photograph or other directory information included in these publications.

Directory Information


News articles for publication in media


Other

 

PAYMENT INFORMATION

Payment Type

 Check
 Credit Card

Check Amount

Check Number

Credit Card Type

 Visa
 Mastercard

Credit Card Number

- - -

Expiration Date

Name on Card

Billing Address Zipcode

 

 

Follow this link back to Ed2Go to complete Ed2Go online registration only.

MGCCC Non-Credit Refund Policy

Registrants will be entitled to a 100 percent refund, provided written notification is received by the appropriate Continuing Education specialist one week prior to the start of class. If the class is canceled, a full refund will be given. A registrant may designate a substitute person to attend if notification is received at least 24 hours prior to the beginning of the class/program. Mississippi Gulf Coast Community College reserves the right to substitute instructors, change class schedules, and cancel programs due to insufficient enrollment or unforeseen circumstances. Any exceptions to this policy must be submitted in writing to the Community Campus vice president or designee for approval.

Mississippi Gulf Coast Community College assures that no one shall, on the grounds of race, religion, color, national origin, sex, age or qualified disability be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination in any program or activity of the College. The Mississippi Gulf Coast Community College is an Equal Opportunity Employer and welcomes students and employees without regard to race, religion, color, national origin, sex, age or qualified disability. Compliance with Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act, Title II of the Age Discrimination Act and Title IX of the Education Amendments of 1972 is coordinated by Dr. Billy Stewart, Vice-President for Administration and Finance, Perkinston Campus, P. O. Box 609, Perkinston, Mississippi 39573, telephone number 601-928-5211, email address billy.stewart@mgccc.edu.

 

 


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