The college is required to have your correct SSN per IRS Code, Section 6109. ?
Personal Information:
* SSN/Student ID:  
* Last Name:   * First Name:   M.I.:
*Mailing Address:   * City:   * State:   * Zip Code:  
* Home Phone:   * Work Phone:   * Date of Birth:  
* Email Address:      
Gender: How did you hear about us?


ETHNIC ORIGIN (Required by the Federal Government)
Are you Hispanic? RACE: Choose one or more (for Non_Hispanics)



By entering my name in the space below, I understand that GCSC will provide my student information to the appropriate agencies for fee payment if I am not paying for this course and/or for licensure/CEU purposes, if required.
* Student Signature:   Date:
State Regulated Professional License Number:
*CRN#   COURSE # *COURSE TITLE   DATE TIME FEE
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Refund Information: sts must be received by 12:00 pm five workdays before the first day of the class (excluding paid online classes).  Please send a refund request email to the program coordinator for the course for which you are enrolled.  All refunds are issued by check to the person assigned to the student ID listed on the registration. Online classes and hybrid classes are non-refundable once access has been granted.

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You will receive an e-mail notification when your registration has been received with payment instructions. Your class registration will not be complete until the course has been paid. Thank you.