ITI-Community Engagement

ITI Community Engagement Registration Form

Student Information

Last Name *This question is required.

First Name *This question is required.

MC Number

Birth Date *This question is required.

Street Address *This question is required. Do NOT use P.O. Box or you will be charged Non-Md Resident Fee

City *This question is required.

State *This question is required.

Zip *This question is required.

Email Address *This question is required. This question requires a valid email address.

Phone

Race (select all that apply)Disclosure not mandatory by Montgomery College, but is required by the U.S. Department of Education

Please list here *This question is required.

Select all that apply

These questions pertain to Maryland residents as defined in the Montgomery College Catalog.
Maryland residents who are 60+ years of age or older are eligible for a student discount for courses designated "Tuition Waiver Applies" TWA.
Maryland National Guard members may be eligible for a tuition discount, but must submit proof of enlistment for 24 month period from the adjutant general's office.

I have been a Maryland Resident for at least three months.
I am 60 years of age or older and a Maryland Resident.
I am a Maryland National Guard member.

Select the one class session you wish to take. All classes are delivered remotely and have 12 sessions from 6:30 p.m. - 8:30 p.m.. *This question is required.

These are listed by CRN#, Title, Days, Start Date, Times.
All Classes are delivered Remotely and have 12 sessions.

By typing my first and last name, I certify that this information is correct and complete, and I agree to abide by the policies and procedures of Montgomery College *This question is required.

Date *This question is required.