Registration Form

 Fall  Spring 
✔ 2021 of
Summer________

Admissions & Registration  P.O. Box 929  Yuma, AZ 85366-0929  (928) 317-6100  fax (928) 344-7543

Student Information (please print) 09/01/1972

Date of Birth _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0388864
AWC ID# _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
DeMack
Name Last _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ David
First _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ M.I. _ _ _ _ _ _ _ _ _ _


✔ My information on file is correct. (Skip to Add/Drop section.)  I am updating my information.

Address Street (P.O. Box) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Phone # Home _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

City _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ State _ _ _ _ _ _ _ _ Zip _ _ _ _ _ _ _ _ _ _ _ _ _ _ Work _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

AWC Email Address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Cell _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Program of Study A list of programs (majors) is located on the back. Please enter your major code:

Add (Course-Section # example —ACC-111-003)

Course Class Class Credit Credit/ Instructor
Course-Section Number
Title Days Time Hours No Credit Signature

CIS-105-700 Intro: Business Info. Sys./GE 3

Drop
Course Class Class Credit Credit/ Instructor
Course-Section Number
Title Days Time Hours No Credit Signature

It is my understanding that my academic advisor responsibility is solely to provide recommendation based upon the information available
and/or provided by me at the time this registration form is completed. It then becomes my responsibility for registering in the classes. Any
changes made on this registration form after the academic advisor has recorded a signature will also become my responsibility.
Digitally signed by David DeMack II
David DeMack II
Student Signature _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
DN: cn=David DeMack II, o, ou, [email protected], c=US
Date: 2021.05.27 13:56:30 -07'00' 05/27/2021
Date _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

For Office Use Only

Advisor Signature _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Code _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Signature for Overloads _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Associate Dean/Dean Signature _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Reason  Capacity  Pre-requisite  Corequisite  Time Conflict  Other _______________________________

Comments _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Processed by _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Datatel ID _ _ _ _ _ _ _ _ _ _ Date _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

White Copy: Admissions & Registration Yellow Copy: Student
Programs of Study Check One: Advisors are available in the College Community Center (3C) to help you select a program of study.
A.A. Degree (for University Transfer) . . . . . Major Code A.A.S. Degree continued Occupational Certificates continued

 Administration of Justice . . . . . . . . . . . . . . . . . . . . . ADMJU  Computer Information Systems . . . . . . . . . . . . . . . CISYS  Culinary Arts w/Focus in Entrepreneurship . . CAENT
 Agricultural Science . . . . . . . . . . . . . . . . . . . . . . . . . AGRIC  Construction Trades Management . . . . . . . . . . . . . . CTM  Custodial Management . . . . . . . . . . . . . . . . . . . . . CUSMG
 Art: Graphics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ARTGR  Early Childhood Education . . . . . . . . . . . . . . . . . . . . . ECE  Detention Officer Operations . . . . . . . . . . . . . . . . DETOF

 Art: Studio Art . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ARTST  Electrical Technology . . . . . . . . . . . . . . . . . . . . . . . . . ELECT  Dietetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DIETP

 Elementary Education: Early Childhood Ed . . . EDECE  EMS: Paramedic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . EMSPA  Early Childhood Education . . . . . . . . . . . . . . . . . . . . . ECE

 Secondary Education . . . . . . . . . . . . . . . . . . . . . . . . EDSEC  Fire Science . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FIRSC  Electrical Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . ECT

 English . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ENGLI  Industrial Technology . . . . . . . . . . . . . . . . . . . . . . . . . . INDST  EMS: Paramedic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . EMSPA

 Family Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FAS  Industrial Water Treatment . . . . . . . . . . . . . . . . . . . . . . . IWT  EMT: Basic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . EMSBA

✔ General Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GENST  Law Enforcement Training . . . . . . . . . . . . . . . . . . . . . . . LET  Engineering Technology . . . . . . . . . . . . . . . . . . . . . . EGRTC

 History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HISTO  Logistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LOGI  Entrepreneurial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ENTEM

 Hotel/Restaurant Management . . . . . . . . . . . . . . HOTEL  Marketing & Management . . . . . . . . . . . . . . . . . . . MKTMG  Family Childcare Education . . . . . . . . . . . . . . . . . . FACHE

 Mathematics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MATHE  Massage Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . MASTH  Family Development Credential . . . . . . . . . . . . . . . . . FDC

 Media Arts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MDART  Media Arts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MDART  Fire Academy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FIREA

 Music . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MUSIC  Microcomputer Business Application . . . . . . . . MICBA  Foundations of Construction . . . . . . . . . . . . . . . . . . FNDC

 Philosophy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PHILO  Nursing: Healing Community . . . . . . . . . . . . . . . NURHC  Green Construction Methods . . . . . . . . . . . . . . . GRCON

 Political Science . . . . . . . . . . . . . . . . . . . . . . . . . . . . . POLSC  Pre-RN (nursing pre-reqs only) . . . . . . . . . . . . . . PRERN  Industrial Graphics: Drafting/CAD . . . . . . . . . . . INDSG

 Psychology/Sociology . . . . . . . . . . . . . . . . . . . . . . . PSYSO  Office Administration . . . . . . . . . . . . . . . . . . . . . . . . OFFAD  Industrial Water Treatment . . . . . . . . . . . . . . . . . . . . . . . IWT

 Spanish . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SPANI  Paralegal Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LEGAL  Infant and Toddler Education . . . . . . . . . . . . . . . . . INTOE

 Theatre . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . THETR  Plumbing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLMB  Law Enforcement Training Academy . . . . . . . . . . . . LETA

A.S. Degree (for University Transfer) . . . . . Major Code  Radiologic Technology . . . . . . . . . . . . . . . . . . . . . . . . RADTE  Logistics: Advanced . . . . . . . . . . . . . . . . . . . . . . . . . LGSAD

 Recreation Management . . . . . . . . . . . . . . . . . . . . RECMG  Logistics: Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LGSBA

 Biology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BIOLO
 Manufacturing Equipment Maintenance
 Solar Technology: Electrical Option . . . . . . . . SOLEO
 Chemistry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CHEMI and Repair Technology . . . . . . . . . . . . . . . . . . . . . . MEMRT
 Solar Technology: Manufacturing Option . . . SOLMO
 Crop Production . . . . . . . . . . . . . . . . . . . . . . . . . . . . CRPRO  Masonry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MAS
 Television Production . . . . . . . . . . . . . . . . . . . . . . . . TVPRO
 Engineering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ENGIN  Massage Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . MASTH
 Welding Technology . . . . . . . . . . . . . . . . . . . . . . . . . WELDT
 Environmental Sciences: Biology Emphasis . . . . ESBIO  Media Arts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MDART
 Environmental Sciences: Geology Emphasis . ESGEO Occupational Certificates . . . . . . . . . . . . . . Major Code
 Microcomputer Business Applications . . . . . . MICBA
 General Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GENST  Accounting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ACCT  Networking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NETWK
 Geology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GEOLO  Agriculture, Occupational . . . . . . . . . . . . . . . . . . . AGOCC  Nursing Assistant . . . . . . . . . . . . . . . . . . . . . . . . . . . . NURAS
 Physics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PHYSI  Air Conditioning & Refrigeration . . . . . . . . . . . . . AIRCR  Office Administration . . . . . . . . . . . . . . . . . . . . . . . . OFFAD

A.BUS Degree (for University Transfer) . . Major Code  Architectural Technology . . . . . . . . . . . . . . . . . . . . . . ARCH  Paralegal Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LEGAL
 Athletic Coaching . . . . . . . . . . . . . . . . . . . . . . . . . . . ATHCH  Personal Trainer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PTR
 Business . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BUSIN
 Automotive Technology . . . . . . . . . . . . . . . . . . . . . . . AUTOT  Plumbing Technology . . . . . . . . . . . . . . . . . . . . . . . . . . PLMB
A.G.S. Degree
(for Individualized Program) . . . . . . . . . . . . . . . . Major Code
 Automotive Brakes and Suspension . . . . . . . . . AUTBR  Practical Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NURPN
 Automotive Computer Fundamentals . . . . . . . . AUTCD  Preschool Education . . . . . . . . . . . . . . . . . . . . . . . . . PRSCE
 Associate in General Studies . . . . . . . . . . . . . . . . GENST Engine Performance and Diagnostics
 Recreation Management . . . . . . . . . . . . . . . . . . . . RECMG
A.A.S. Degree  Automotive Electrical and Air Conditioning . . . AUTAC
 Retail Management . . . . . . . . . . . . . . . . . . . . . . . . . . RETMG
(Occupational Degrees) . . . . . . . . . . . . . . . . . . . . Major Code  Automotive Power Trains . . . . . . . . . . . . . . . . . . . . . AUTPT
 Solar Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SOLAR
 Accounting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ACCT  AWS (American Welding Society)
 Spanish Language Proficiency . . . . . . . . . . . . . . . . . SPAN
Entry Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AWS
 Administration of Justice . . . . . . . . . . . . . . . . . . . . . ADMJU  Welding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . WELDG
 Basic Air Conditoning and . . . . . . . . . . . . . . . . . . . . . BACT
 Air Conditioning & Refrigeration . . . . . . . . . . . . . . AIRCR
Refrigeration Service Technician  Welding Certificate of Proficiency
GMAW/FCAW Plate . . . . . . . . . . . . . . . . . . . . . . . . GMAW
 Applied Agriculture . . . . . . . . . . . . . . . . . . . . . . . . . AGBUS
 Basic Carpentry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BCARP
 Architectural Technology . . . . . . . . . . . . . . . . . . . . . . ARCH  Welding Certificate of Proficiency
 Basic Custodial Maintenance . . . . . . . . . . . . . . . . . . CUST SMAW Plate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SMAW
 Automotive Technology . . . . . . . . . . . . . . . . . . . . . . . AUTOT
 Basic Electrical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BELEC
Other
 Broadcasting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BRDCA
 Basic Plumbing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BPLMB
 General Business . . . . . . . . . . . . . . . . . . . . . . . . . . . BUSGN
 Business Entrepreneur . . . . . . . . . . . . . . . . . . . . . . . . . . . ENT  AZ General Ed. Curriculum: Arts . . . . . . . . AGECA

 Carpentry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CARP
 Carpentry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CARP  AZ General Ed. Curriculum: Business . . AGECB

 Civil Engineering Technology . . . . . . . . . . . . . . . . . . . . CET

 Computer Information Systems . . . . . . . . . . . . . . . CISYS  AZ General Ed. Curriculum: Science . . . AGECS

 Computer Graphics . . . . . . . . . . . . . . . . . . . . . . . . COMGR

 Computer Security . . . . . . . . . . . . . . . . . . . . . . . . . . COMSE  Personal Enrichment . . . . . . . . . . . . . . . . . . . . . . PEREN

 Culinary Arts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CULAR

Arizona Western College does not discriminate in admission or access to, or treatment of employment in, its
services, programs, or activities regardless of race, color, national origin, sex, religion, age (40+), and disability.