CEWD - CFK Registration

Please submit a separate registration for each child.

Please fill out this form to begin your registration. After submission, Norwalk Community College will contact you by telephone for payment information.
Required fields are marked with an *

Child's Full Name(*)

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Child's Upcoming Grade(*)

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Child's Student ID - If child is a returning student, please enter their 8 digit Student ID. This will help speed up processing your registration.

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Parent/Guardian Information

Parent/Guardian's Full Name - If you have legally changed your name, please include your previous name here so we can make sure not to create a duplicate account.(*)

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Email(*)

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Primary Phone(*)

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Secondary Phone

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Permanent Mailing Address(*)

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New Mailing Address? - If you've registered with us before, is this mailing address above a new address?

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Emergency Contact(s)

Please add up to two emergency contacts for the child.

Full Name and Phone Number(*)

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Pick Up Information

Please enter up to 2 contacts who will be authorized to pick up the child.

Full Name and Phone Number(*)

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Full Name and Phone Number

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Full Name and Phone Number

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Course Details

Please enter the details of the course(s) you'd like to register for.

CRN - 4 digit number

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Course Title

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Starting Date

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Fee

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Total Cost

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Disclosures

The college reserves the right to cancel classes or limit class size. The semester Course Schedule is subject to change.

Please toggle each option below to confirm that you have read and agreed to the following policies.

Medication & Emergencies: Medication cannot be administered by any employee of NCC. If a medical issue should arise, your child will be transported to the nearest hospital.

Do you consent to this policy?(*)

I Agree Invalid Input

Refund Policy: A student who withdraws within 72 hours prior to the class start date is entitled to a full refund. No refund will be made after the first class meeting of the course except in cases of: serious illness, call to active military duty, or other extenuating circumstances. Documentation will be required by the Division of Continuing Education to support the refund appeal.

Do you consent to this policy?(*)

I Agree Invalid Input

Photo Policy: NCC often takes or commissions photos and videotapes of students, faculty, staff, and campus visitors. These images are taken in classrooms, labs, study areas, as well as College events around the campus. NCC reserves the right to use the photographs/video clips as part of its publicity and marketing efforts. Students who enroll at NCC do so with the understanding that these photographs might include them and might be used in College publications, both printed and electronic, and for publicity. If you do not want your child photographed, contact Continuing Ed. at (203) 857-7080.

Do you consent to this policy?(*)

I Agree Invalid Input

Course Format: I understand that in the event of an outbreak of the coronavirus or other illness, the institutions reserve the right to adapt the format of any class to an entirely online/distance learning modality as public health conditions warrant. Such change will not result in any increase or decrease of tuition and fees

Do you consent to this policy?(*)

I Agree Invalid Input