Request Information

Have questions or want to speak with an Admissions Counselor? Submit a request below to let us know what program(s) you are interested in and how we can get in touch with you.

* Denotes a required field.

First Name*

Last Name*

Maiden Name

Date of Birth*

Email*

Phone*

Address*

City*

State*

Zip*

Program of Interest*

Second Program of Interest (if applicable)

When do you plan to enroll at NICC?*

Fall Semester (August)

Spring Semester (January)

Summer Term (May)

Are you a veteran or military affiliated?*

Yes

No