Enrollment Confirmation





In addition, select one or more of the following racial categories to describe yourself








Choose all that apply
















NYS Public Law 2165 requires students to be immunized for Measles, Mumps, and Rubella. Also, NYS Public Law 2167 requires students to submit a Meningitis Notification Form. Students not in compliance 30 days after attending the first class will be DISMISSED (May not return during current semester). All documentation should be submitted to Health Services, 330 Powell Ave., Newburgh, NY 12550.

Please type your first and last name
Today's Date (MM/dd/yy)