Readmit / Reactivation Form

Passaic County Community College Office of Admission

* First Name

Middle Initial

* Last Name

Date of Birth

Social Security Number

Your SSN is needed if you intend
to apply for financial aid (xxx-xxx-xxxx)

* Street Address

Apartment (if any)

* City

* State

* ZIP Code

* Have you been a resident of the state of New Jersey for the last 12 months?

Yes No

* Email Address

* Cell Phone Number

Home Phone Number

PCCC 7 Digit Student I.D. #

Are you a graduate of PCCC?

Yes No

* Please indicate what type of student you will be

* Please select a start term

* Please indicate which campus you will be attending

* Do you intend to earn a Degree or Certificate?

Yes No

* Academic Program

If You Attended Another College Since you last attended PCCC, list college name and dates of attendance.

College

Look it up

College Name

City

State

Date Attended From

Date Attended To

Both the State and Federal Governments periodically require that we submit information on the characteristics of our students. Your response to this section is voluntary but will help us in implementing our affirmative action policy. PCCC is an equal opportunity institution. This information does not affect admission or placement.

(Please click here for definitions of the following designations as indicated in the Federal Register). Please respond to both questions.

Ethnicity

Hispanic
Non-Hispanic

Race

To complete the form please click the 'Submit' button below.

Official Mailing Address

Passaic County Community College
One College Boulevard
Paterson, NJ 07505-1179
Att. Bursar

Office Hours

Mon/ Tues / Wed/ Fri*
8:30am to 4:30pm

Thurs
8:30am to 7:00pm

Sat/Sun
CLOSED
*Closed Fridays in summer

Enrollment Services
Main Campus/Paterson
125 Market Street
Paterson, NJ 07505