College Bridge Program Registration - Newcomb

If you see this don't fill out this input box.

Student First Name*Student First Name

Student Last Name*Student Last Name

Student Middle Initial*Student Middle Initial

Social Security Number*SSN- Do not enter zeros or you will not be registered

Date of Birth*Date of Birth

Mailing Address*Street Name/Number/ Or PO BOX

Home City*

Home State*

Home Zip Code*

Family Telephone Number*

Student Email Address*Do not use your school email

County of Residence* Please Select Essex Franklin Hamilton St. Lawrence Lewis Clinton Warren WashingtonCounty of Residence

High School Level* Please Select Junior Senior

Citizenship* Please Select I am a US Citizen I am NOT a US Citizen I am an International Student

Gender* Please Select Female Male Other/Non-Binary

Ethnicity (Optional) Please Select American Indian/Alaskan Native Native Hawaiian/Pacific Islander Asian White Black/African American Hispanic Two or More RacesEthnicity (Optional)

Location Courses

BUS 101 ENW - Introduction to Financial Accounting

ECO 101 ENW - Intro Macroeconomics

ENG 108 ENW - Intro to Creative Writing

MAT 129 ENW - Intermediate Algebra

PHY 101 ENW - Principles of Physics I

PHY 101 ENW1 - Principles of Physics I Lab

POS 102 ENW - American Govt and Politics

Please check the boxes of the classes you will be taking for college credit this year:

Signature

I understand that by signing this registration form I am formally enrolling in courses offered by North Country Community College at my high school. I have indicated my choice on the form below. I understand that New York State Education Law allows me to enroll in these courses without a signature from my parent or guardian.

I am responsible for paying $75 for each course I select below. I understand that I will receive a green bill at my mailing address which I will have to pay unless I formally drop these courses before October 15 2026. I can inform my instructor and/or guidance counselor prior to that date. If I do not I will still have to pay for the course even if I choose not to participate at a date after October 15 2026.

I further understand that I will need to provide my social security number to facilitate official enrollment receipt of transcripts and reporting processes as established under Section 355 of the Education law of the State of New York. If I do not provide my social security number by October 18 2026, I will be removed from the program without notice.

Signature

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