Non-Degree Student Application Procedure Use this form only if you have never attended or applied to SCCC, and you wish to take classes without being admitted to a degree program. Prior applicants can register immediately online. If you would like to apply to a specific degree program please go to Admissions and apply online. Please allow one business day for this application to be processed prior to registering. You can also apply by completing the printable form.
Non-Degree Student Application Form
² First Name
MI
² Last Name
² Date of Birth
Former Name
² HS Grad Date
² Home Phone
( ) –
² E-Mail
Work Phone
( ) –
² Please complete all required fields ²
Personal Information
² Address
² City
² State
² Zip
² County
² SS #
² Country
² Gender
Male Female
² Please Indicate Your Location and Semester
Ammerman at Selden Eastern at Riverhead Grant at Brentwood Sayville Downtown Center
Fall Winter Spring Summer
² Please Indicate Your Status
NY State resident for prior 12 months
Yes No
New Student
Yes No
Suffolk County resident for prior 6 months
Yes No
Veteran
Yes No
Will you be attending SCCC while attending high school?
Yes No
Have you ever been convicted of a felony?
Yes No
Have you ever been suspended from college for disciplinary reasons?
Yes No
School Information
² High School
² College
Optional Information
Ethnic/Racial
Instructions
Complete all the required information above.
Press "Reset" to correct your request.
Press "Send" to mail your request.
Additional Information or Comments – Please enter below:
