Banner ID Number: ______________________________________________________

or Social Security Number: ________________________________________________

Last Name: _____________________________________________________________

First Name: ____________________________________ M.I. _____________________

Home Address: __________________________________________________________

City: _________________________________ State: ___________ Zip: _____________

Daytime Phone (including area code): _________________

Cell Phone: ______________________

Email Address: ____________________________________

List the course you would like to register for below:

CRN	Dept	Course # & Section #	Course Title	Credits

Fax completed form to the Office of Registration and Records at (585) 395-5392
or
Mail completed form to the Office of Registration and Records, The College at Brockport, 350 New Campus Drive, Brockport, NY, 14420-2966.

New-to-the College students must submit The College at Brockport New Student Information Form with the Course Registration Form.

News

Brockport's Class of 2013 Joins Alumni Ranks

Brockport Celebrates 2013 Graduate Student Commencement

The College at Brockport Celebrates Commencement May 17-18

Brockport and Nazareth Forge Partnership with Jefferson Community College

Events

No events found for the next month.