Forms Portal
This form no longer exists. You will not be able to submit this form.
Reset Form
Close Form
Your form is outdated. Click here to update your form to the most current version.
WACC Student Registration
Student Information
Please be aware you must fill out a separate registration for each semester.
First Name
*
Middle Initial
Last Name
*
Student ID
*
Street Address
*
City
*
State
*
Zipcode
*
SSN
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Birthdate
*
Phone Number
*
Grade Level
*
High School Email
*
Term
*
School
*
Spring 2025
Summer 2025
AFC High School
Amboy High School
Bureau Valley High School
Dixon High School
Faith Christian School
Fulton High School
Homeschool
Milledgeville High School
Morrison High School
Newman High School
Ohio High School
Oregon High School
Polo High School
Prophetstown High School
Rock Falls High School
Sterling High School
West Carroll High School
Individual Identification
*Optional but recommended for reporting purposes
Ethnicity
Hispanic or of Hispanic heritage?
Gender
American Indian or Alaska Native
Asian
Black or African American
Middle Eastern or North African
Native Hawaiian or Other Pacific Islander
White
Yes
No
Emergency Contact Information
This information is only necessary if your emergency contract differs from your Parent / Guardian
Contact's First Name
*
Contact's Last Name
*
Relationship to Student
*
Email
*
Phone Number
*
Course Information
Failure to properly indicate your course information may result in you not being registered.
*
Semester
*
Course(s)
Spring 2025
A
CRN
B
Class Name
C
Section
Add New Entry
Electronic Signature
*
Submission Date
*
Save Draft
×
Draft name:
×