College Bridge Program Registration

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

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

Mailing Address*Home Address

Home City*Home City

Home State*Home State

Home Zip Code*Home Zip Code

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

Date of Birth*Time is not important- just put anything

High School Level

Junior

Senior

High School Level

Home High School* Please Select Ausable Valley High School Beekmantown High School Boquet-Valley High School Brasher Falls/St. Lawrence Central High School Brushton-Moira High School Chateaugay High School Chazy High School Clifton-Fine Central School Colton-Pierrepont Central School Crown Point High School Edwards-Knox Central School Franklin Academy High School Gouverneur Central School Hammond Central School Harrisville Central School Hermon-DeKalb Central Heuvelton Central School H. C. Williams High School (Canton) Indian Lake High School Keene High School Lake Placid High School Lisbon Central School Long Lake High School Madrid-Waddington Central School Massena Central School Minerva High School Moriah High School Morristown Central School Newcomb High School Northern Adirondack High School Northeastern Clinton High School Norwood-Norfolk Central School Ogdensburg City School Other Parishville-Hopkinton High School Peru High School Plattsburgh High School Potsdam Central School Salmon River High School Saranac Lake High School Schroon Lake High School St. Regis Falls High School Ticonderoga High School Tupper Lake High School Wells High School Willsboro High School Westport High School

College Bridge Program Location* Please Select Boquet-Valley High School Brasher Falls/St. Lawrence Central High School Brushton-Moira High School Chateaugay High School Crown Point High School CVTECH @ Mineville CVTECH @ Plattsburgh Franklin Academy High School Harrsiville Indian Lake High School Keene High School Lake Placid High School Long Lake High School Minerva High School Moriah High School New Visions Newcomb High School Parishville-Hopkinton High School Salmon River High School Saranac Lake High School Schroon Lake High School St. Lawrence/Lewis @ Norwood St. Lawrence/Lewis @ Ogdensburg St. Lawrence/Lewis @ Fowler St. Regis Falls High School Ticonderoga High School Tupper Lake High School Westport High School Wells High School Willsboro High SchoolCollege Bridge Program Location

Family Telephone Number*Family Telephone Number

Student Email Address*Student Personal Email Address- (not High School)

Gender

Female

Male

Other/Non-Binary

Gender

Citizenship

I am a US Citizen

I am not a US Citizen

I am an international student

Citizenship

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

Signature

I understand I am formally enrolling in courses offered by NCCC at my high school. I understand that NYS Education Law allows me to enroll in these courses without a signature from my parent or guardian. I am responsible for successfully completing each course I select on the registration days unless I formally drop these courses before November 1, 2025.

Signature

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