Continuing Education Division Registration Form

Student Information

On-line registration requires payment with a credit card or fill in the appropriate information, print the form and mail it to:

Aims Community College

5590 West 11th Street

Greeley, CO  80634

Attention:  Registrar/Continuing Education

    If you are enrolling in a class with 24 hours of the class start,

please confirm by phone  970-339-6213 or 1-800-301-5388-ext 6213.

All fields required to process registration

Aims Student ID#  if known   Example A-00000000

   
Legal Name (Last, First, Middle)
Gender Male   Female 
Date of Birth  (mm-dd-yyyy)

Mailing Address
City, State, Zip ,    
Street Address (If different from above)
City, State, Zip ,    
Email

Home Phone (Including Area Code) --
Work Phone (Including Area Code) -- *
Cell Phone (Including Area Code) --

Course Title CRN Number Course Number Start Date Time Fee

$
$
$
$
$
$
$
$
$
On-line registration requires payment with a credit card.  Your card will be charged when your registration is processed.  If you prefer to pay with cash or check, please print this page and mail to the above address or personally deliver the registration and fee to the Aims Corporate Education Center or Aims Community College Campus.
Payment Type: Total Cost $
Visa --- Expiration Date
MasterCard --- Expiration Date
Discover --- Expiration Date
 
 

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Revised:  May 09, 2008

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