Thomas College
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Student Registration-Satellite Courses

Thomas College would like to provide you the best possible personalized information and services. This form is used to register for a Thomas College satellite course. If you have any questions, please call our Graduate and Professional Studies office at 207-859-1102 (+12078591102).

First Name:
Preferred First Name (Nickname):
Middle Name:
Last Name:
Suffix (example: Jr/Sr):
Former Last Name:
Street Address:
Street Address:
(if more space needed)
Town/City:
State:
Postal/Zip Code:
Country:
E-mail Address:
Mobile (Cell) Phone Number:
(without dashes)
Social Security Number (without dashes):
(Required for IRS 1098T Tuition Tax Statement.)
Birth Date (M/D/Y):
Sex:
Town/City of Residence:
Racial/Ethnic Code?
(Not required)
Employer Name:
Your Position:
I Have Attended Thomas Before:    Year Attended:
U.S. Citizen/Permanent Resident:
How do you prefer to be contacted?
What course(s) are you registering for?