New Student Student On-Line Registration


Please complete the following form to register for a class at CPTC. When you are finished, click on the Register button at the bottom of the page.

Please note, this form is for students new to CPTC. If you are returning, and have an SID and PIN, please use the online registration page.

Thank you.

 Current Information

Soc Sec No:

Your social security number is confidential and, under a federal law called the Family Educational Rights Privacy Act, the college will protect it from unauthorized use and/or disclosure. In compliance with state/federal requirements, disclosure may be authorized for the purposes of state and federal financial aid, Hope/Lifetime Learning tax credits, academic transcripts, assessment or accountability research. Disclosure of your social security number (SSN) is voluntary. A Student ID number (SID) and Personal ID Number (PIN) will be assigned to you for the purpose of accessing your college records. (Ref PL93-579 7A1)
I do not wish to disclose my social security number.

I authorize this college to use my Social Security Number to obtain employment and wage information held by the Employment Security Department for the purposes of state and federal educational reporting, evaluation and research.
Yes, I give my consent.    No, I do not consent to the use of my SSN for the above stated purpose.

Name: (Last, First M.I.) REQUIRED
(press enter
for new lines)
Day Phone: (Please include your area code)
Evening Phone: (Please include your area code)
Please double-check your E-mail address. If it is inaccurate, we may not be able to contact you. Thank you.
Birth Date: (M/D/Y)
Sex: Male   Female
 Class Registration
Class Title Class Fee
 Method of Payment
Credit Card

Credit Card Logos
Credit card payment is processed through our Online Fee Payment page. Once your registration is processed, you will be sent an SID and PIN, then you can use the Pay Fees Online page.

If you prefer not to send your credit card number over the Internet, you may telephone it to the Office of the Registrar at (253)589-5666. If you choose that option we cannot process your registration until you call your number in.)


Check or Money Order
(Please do not send cash.)
Mail to:

Clover Park Technical College
4500 Steilacoom Blvd S W
Lakewood WA 98499-4098

 Educational Background
Last High School Attended:


City: State: 
Last Year Attended: Graduated:  Yes  No

Last College Attended:


City: State: 
Last Year Attended: Graduated:  Yes  No
 In each category below, please click the one option that best applies to you
Ethnic Origin: White Black/African-American Eskimo Aleut
Indian (Amer) List enrolled or principal tribe:  Chinese Filipino Hawaiian Korean Vietnamese Japanese Asian Indian Samoan Guamanian
Other Asian or Pacific islander: (indicate)
Other Race:
Are you of Spanish or Hispanic origin? No (If yes, please check the line below that best describes you.)
Mexican, Mexican-American, Chicano
Puerto Rican
Other Spanish or Hispanic: (eg: Argentinean, Colombian, etc.) (Indicate)
U.S. Citizen? Yes No (If not U.S. Citizen, country of citizenship)
Limited English Proficiency? Yes (An individual not born in the United States or whose native language is a language other than English, and who by reason thereof, has sufficient difficulty speaking, reading, writing or understanding the English language.)
Disability? Yes (Do you have physical, sensory or mental impairment that substantially limits one or more of the major life functions such as seeing, hearing, speaking, walking, breathing, working with your hands, learning, caring for self and working? To request accommodations, contact Advising/Counseling (253)589-5767.)
 Student Purpose

What is your goal for attending CPTC?
Take courses related to current/future work(11)
Transfer to a four-year college(12)
High school diploma or GED(13)
Explore career direction(14)
Personal enrichment(15)

How long do you plan to attend CPTC?
One quarter(11)
Two quarters(12)
One year (Diploma or Certificate)(13)
Two years (Diploma or Certificate)(14)
Complete a degree(15)
Don't know(16)


What is your current working status while attending CPTC?
Full-time homemaker(11)
Full-time employment (including self-employed or military)(12)
Part-time off-campus(13)
Part-time on-campus(14)
Not employed, but seeking employment(15)
Not employed, and not seeking employment(16)


What is your prior level of education at entry to CPTC?
Less than a high school graduation(11)
High school graduate(13)
Some post high school, but no degree or certificate(14)
Associate Degree(16)
Bachelor's Degree or above(17)


What is your family status?
A single parent with children or other dependents(11)
A couple with children or other dependents in your care(12)
Without children or other dependents in your care(13)


Please check this box if you are a veteran(Z)

(Veterans and/or their dependents may qualify for educational benefits. Please call the VA at 1-888-442-4551 or go to for more information.)

The college appreciates your response to the following questions. All information will be maintained in the strictest confidentiality.

What is your sexual orientation?
Prefer not to answer(57)


What is your gender identity?
Gender neutral(35)
Prefer not to answer(57)


By clicking “Register” below, student agrees to be bound by CPTC policies and procedures as set forth in the student handbook and online.

Students are responsible for all collection fees, attorney fees and court fees in accordance with RCW 28B.10.293 and RCW 19.16.500 should they default on any financial obligations for CPTC.

Please note, registrations are processed during normal business hours (8AM-5PM, M-F, Pacific time).

Please remember to click the Register button to complete your registration.

You will be officially registered upon receipt of charge authorization or payment.

Please direct any questions to the Office of the Registrar. Thank you.

LIMIT OF LIABILILTY: The college's total liability for claims arising from a contractual relationship with the student in any way related to classes or programs shall be limited to the tuition and expenses paid by the student to the College for those classes or programs. In no event shall the college be liable for any special, indirect, incidental, or consequential damages, including but not limited to, loss of earnings or profits.

NON-DISCRIMINATION POLICY: Clover Park Technical College has policies regarding non-discrimination on the basis of race, color, sex, religion, creed, age, marital status, national origin, sexual orientation, veteran status, or the presence of any physical, sensory or mental disability. Any person at the college who feels he or she has reason to claim discrimination or unfair treatment may contact Human Resources to speak to an Equity Representative, - Shelby Fritz.

Home | Programs | E-mail ]