Iowa Central Distance Learning Enrollment Form

If you have not completed an application, please fill out our free application by clicking on the “Apply Now” link.  All students must apply prior to enrolling into classes. 

* indicates a required field

Personal Information
*
First Name:
A value is required.
*
Last Name:
A value is required.
*
SSN:
A value is required.
*
Date of Birth:
A value is required.
*
Address:
A value is required.
*
City:
A value is required.
*
State:
A value is required.
*
Zip Code:
A value is required.
*
Phone:
A value is required.
*
E-Mail:
A value is required.Invalid format.


Enrollment Information
* First, select how you plan to take classes at Iowa Central: Please select an item.
* Then select ONE program you are planning to major in from the options available: Please select an item.
*
Term:

Online Classes Offered
Please select from the following list of online classes offered. If you are not sure which classes you would like to take, please contact our Admissions Office and speak with an advisor prior to enrolling into classes.



You must check the box to the left in order to submit the form.
By checking this box I certify that the above statements are true and correct to the best of my knowledge. I agree to abide by all approved policies as outlined in the current issue of the college catalog. I agree to report all changes, including name and address, to the Admissions Office.

Non-Discrimination Statement
It is the policy of Iowa Central Community College not to discriminate in its programs, activities, or employment on the basis of race, color, national origin, sex, disability, age, sexual orientation, gender identity, creed, religion, and actual or potential family, parental, or marital status.

If you have questions or complaints related to compliance with this policy, please contact Stacy Ihrig, Executive Director of Human Resources, One Triton Circle, Fort Dodge, Iowa, 50501, Telephone: (515)-574-1138, Email:  concerns@iowacentral.edu, or the Director of the Office for Civil Rights U.S. Department of Education, John C. Kluczynski Federal Building, 230 S. Dearborn Street, 37th Floor, Chicago, IL 60604-7204, Telephone: (312) 730-1560, Facsimile: (312) 730-1576, TDD 800-877-8339 Email: OCR.Chicago@ed.gov.

You must fill out the reCaptcha below to continue!