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Home » Public Safety Registration

Public Safety Registration

Please Note: Submitting this registration form does not automatically register you for the course(s). You will receive an email confirming your registration has been processed within two (2) business days.

Public Safety Continuing Education Registration Form

Course: * Required
Name: * Required
First Middle Last
Date of Birth: * Required
MM slash DD slash YYYY
Social Security Number or SPCC Student ID:
Preferred Email: * Required
Preferred Phone: * Required
Name of North Carolina Police, Fire, EMS, or Rescue Dept.: * Required
Job Classification: * Required
- Firefighter (Vol Agency)
- EMS Responder (Vol Agency)
- Emergency Mgt. Personnel
- Telecommunicator/Dispatcher
- Detention Officer
- Firefighter (County/State/Municipal)
- EMS Responder (County/State/Municipal)
- Named in EOP
- LE Officer
- DPS DAC/DJJ
Student Signature: My signature attests that I am actively affiliated with the North Carolina public safety agency listed above, that I hold the job classification indicated, and that the content offered in this class is necessitated by duties in my current position. * Required
Date of Signature: * Required
MM slash DD slash YYYY

*Class registration fee waiver is contingent upon your active affiliation with an eligible North Carolina public safety agency. If you are not currently affiliated with an eligible North Carolina agency, you must pay the registration fee in order to participate in the class.
Are you a first-time student at SPCC? * Required
- Yes
- No
Address: * Required
Street Address County City State Zip Code
Home Phone: * Required
Work Phone:
Cell Phone:
Highest Education Level: * Required
- Non-Graduate
- GED
- H.S. Graduate
- Adult H.S. Diploma
- 1-Yr. Vocational Diploma
- Associate Degree
- Bachelor’s Degree
- Master’s Degree or Higher
Employment Status: * Required
- Full-Time
- Part-Time
- Retired
- Unemployed-Not Seeking
- Unemployed-Seeking
Sex: * Required
- Male
- Female
Race/Ethnicity: * Required
- Hispanic or Latino
- American Indian or Native Alaskan
- Asian
- Black or African American
- Native Hawaiian or other Pacific Islander
- White

L.L. Polk Campus

680 US 74
Polkton, NC 28135
704.272.5300

Monday-Thursday 8am -5pm
Friday 8am - 3pm

Lockhart-Taylor Center

514 N. Washington St,
Wadesboro, NC 28170
704.272.5400

Monday-Thursday 8am -5pm
Friday 8am - 3pm

Old Charlotte Highway Campus

4209 Old Charlotte Highway
Monroe, NC 28110
704.290.5100

Monday-Thursday 8am -5pm
Friday 8am - 3pm

Tyson Family Center for Technology

3509 Old Charlotte Highway
Monroe, NC 28110
704.290.5100

Monday-Thursday 8am -5pm
Friday 8am - 3pm

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