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Request for Information

Can't find what you're looking for?
While much information is now available online, we understand that many people prefer to have some materials mailed to them. Or they may wish to be notified by email about things like early registration or various programs and events.

Please complete this Information Request Form so we can respond promptly.

NOTE: Information you give is for college tracking and assessment purposes only and will not be shared with anyone else. Some fields are optional, but others are required* to enable us to process your request.

*First Name:
*Middle Initial:
*Last Name:
*Mailing Address:
*City:
*State:
*Zip:
*Daytime Phone:
*Evening Phone:
*Email Address:
 
*Campus most convenient to you:
*Requesting information for:
*Please mail me the following: Catalog (available online)
  Current Credit Class Schedule (available online)
  RN Nursing Program Packet
  LVN Nursing Program Packet
  Current Continuing Education Schedule (online)
  Application for Admission (available online)
  Scholarship Application (available online)
  Housing Application
  Other
 
What other kinds of information can we provide?
 
Thanks for supplying the following information:
This and all other optional information is requested for statistical purposes ONLY and will be kept strictly confidential.
 
Gender: Male Female
Ethnicity: White (Non-Hispanic)
Black (Non-Hispanic)
Hispanic
American Indian/Alaskan Native
Asian/Pacific Islander, Other
 
How interested are you in NCTC? Likely to apply
Considering applying
Uncertain at this time
In choosing a college is NCTC your: 1st choice
2nd choice
3rd choice
Plan to Attend College: Fall
Spring
Summer
Year:
Would financing your college be: Very difficult
Somewhat difficult
Not difficult
I'm wanting to know more
about NCTC because of
information I first got from:		 High school counselor
Word of mouth from friend, co-worker, etc.
Brochure or Other Printed Material
NCTC Website
Radio or TV commercial
Newspaper article
Newspaper advertisement
Movie theater advertisement
Something mailed to me by the college