Open Hillsborough Homepage

E-Mail Registration Form

(813) 253-7982

Registering for an OnLine

Please enter the requested information..

* Choose the course you wish to enroll in

* Enter the Course Reference number
Please enter the complete reference number. (Example: RMI-8234-73305.) NOTE: If "TBA" is shown, use date..


(CE) Life
  D.O.I. #40321 course # 14062
Course Ref Date
RMI-8234 Open Registration

(CE) Health
    D.O.I. #40322 course # 14060
Course Ref Date
RMI-8234 Open Registration

(CE) Ethics
  D.O.I. #53604 course # 114063
Course Ref Date
RMI-8279 Open Registration

(CE) Flood
  D.O.I. #59082 course # 14058
Course Ref Date
RMI-8276 Open Registration

(CE) Ethics & Client
  D.O.I. #(60889) course # 14058
Course Ref Date
RMI-8277 Open Registration

(CE) Health Svg Acct
  D.O.I. #(57324) course # 14058
Course Ref Date
RMI-8278 Open Registration

2-15
Life, Health and Annuities Pre-Licensing Completely Online Including Final Exam
course # 14058--- Provider # 0443
Course Ref Date
 RMI-8230

Open Registration

 

2-15
Life, Health and Annuities PassPrep
course # 14061
Course Ref Date Time
RMI-8231 Open Registration Completely Online

2-20
General Lines Insurance Completely Online Including Final Exam
course # 14065--- Provider # 0443
Course Ref Date
RMI-8060 Open Registration

2-20
General Lines PassPrep
Course Ref Date Time
RMI-8232 Open Registration Completely Online

(New!) 2-20 & 20-44 Practice Question Generator

Course Ref. Date Time
TBA Open Registration Completely Online


Personal Lines Agent
Completely Online Including Final Exam
course # 14057--- Provider # 0443
Course Ref Date
RMI-8900 Open Registration
4-40 Registered Customer Service Representative Completely Online Including Final Exam
Provider # 443
Course Ref# Date
RMI-8233 Open Registration
3-20, 5-20, 6-20 Accredited Claims Adjuster Completely Online Including Final Exam
Provider # 443
Course Ref# Date
RMI-8200 Open Registration
* Name (Last, First, Middle Initial)  
* Email or Fax #
*Retype your email address
* Home Phone
*Work Phone

* Permanent Address

Street
City
State Zip Code
*SSN# (123-45-6789) *Date of Birth (day / mo. / yr.) *Sex Male Female
* The following information is requested by the U.S. Office of Education
- Please Select One
White, Non-Hispanic Asian or Pacific Islander American Indian or Alaskan Native
Black, Non-Hispanic Hispanic
* The following information is required for some courses - Please Select One
I am a High school graduate. I am not a high school graduate.
*Residency Statement
I certify that I have resided in Florida as a permanent resident for the past twelve consecutive months or longer or otherwise meet the residency requirements outlined in the law of the State of Florida.
I have not resided in Florida as a permanent resident for the past twelve consecutive months and I do not meet the residency requirements.

*I declare under penalty of perjury punishable by law as a misdemeanor under Section 837.08, F. S., that the forgoing is true and accurate.
I do. I don't.
 
2. Fill out the Credit Card information below and Click Next
*
Don't Forget to fill out all of the Required Fields!
* Name as it appears on the credit card (IF DIFFERENT FROM STUDENT NAME)

* Credit Card Billing Address (IF DIFFERENT FROM STUDENT ADDRESS)

Street

City

State   Zip Code

* Credit Card type Visa  or Master Card 
* Credit Card Number Security Code1 Exp. Date
1 The Security Code, also known as CVV, CVC, or CID, may be found as follows:
Visa and MasterCard - the last 3 digit number located on the back of your card on or above the signature line.
* Card Holder's Email Address or Fax #
(such as yourname@isp.com)
* Card Holder's Phone (xxx-xxx-xxxx)
* I certify that I am the card holder or have the card holder's permission to make this purchase.
I am the card holder I have permission

 Questions or Comments:


HILLSBOROUGH COMMUNITY COLLEGE
NOTIFICATION OF SOCIAL SECURITY NUMBER COLLECTION AND USAGE

Hillsborough Community College (HCC) will only collect and use your social security number (SSN) as needed for lawful purposes within the business of HCC and for those specific purposes identified by the Social Security Administration, the Internal Revenue Service and other state and federal regulatory agencies and related laws. The SSN will not be used in an HCC information system as the primary identification of individuals unless required by law. HCC is committed to protecting the SSN for our students, faculty and staff from unauthorized access, recognizing that identity theft is a growing problem. HCC departments that are authorized and required to collect, transmit, store or use a SSN will do so in a secure manner. Violations of this policy may result in disciplinary action up to and including discharge or dismissal in accordance with HCC rules and procedures.

In compliance with Section 119.071(5), Florida Statutes, this document serves to notify you of the purpose for the collection and usage of your SSN.

HCC collects and uses your SSN only for programs regulated by the Florida Department of Business and Regulation and in performance of the College’s duties and responsibilities. To protect your identity, HCC will protect your SSN from unauthorized access, never release your SSN to unauthorized parties, and assign you a unique student/employee identification number. This unique ID number is used for all associated employment and educational purposes at HCC.

For the student information system (HawkNet), the primary identifier for a student will be the student identification number, which will be used to access student education records, and for electronic and paper data systems that identify track and service students. Faculty and staff will require students to provide their student identification number for all transactions and not SSNs for any transactions requiring access to student records.

Signature: (required)



3. Click Submit -

Last Updated: August 18, 2011 by Talisa Dominguez