Introduction to the Oilfield Online Education Enrollment Form

North Central Kansas Technical College

 Application and Enrollment Form


The North Central Kansas Technical College does not discriminate on the basis of sex, race, color, religion, national origin, age, handicap or marital status in admission or access to, or treatment of, or employment in its programs and activities. If you have questions regarding the below, please contact the NCKTC Dean of Student Services (1.800.658.4655).


Admission Requirements:
The information furnished to the college will not be used to deny admission, but is needed for reporting purposes.


High School students may enroll as special students if they have earned high school junior status and have written permission from their high school principal or counselor. If you have further questions, please contact the Registrar's Office.



1. Please complete all questions as completely and accurately as possible.
2. Submit this form.
3. Pay a $50 application fee and $126.00 per credit hour. All fees must be paid before enrollment is completed

4. Fill out the Liability Waiver Form and return to Janet Moeller, P.O. Box 507, Hwy 24, Beloit, KS  67420



Introduction to the Oilfield Flyer





Tuition Scholarships are available. Applicants need to complete a scholarship form.  Awarded scholarships will be reimbursed to the student upon completion with a grade of "C" or better. Student must pay for the course at enrollment. Next course will begin in June!



* Indicates the question is required to submit the form.


Step 1: Please complete all questions as completely and accurately as possible


*Today's date
*Last name
*First name
*Middle name
Maiden name
*Email address
NOTE: Your E-mail address must be accurate as you will receive confirmation at this address.
*Home Phone
*Cell Phone
*Street address
*Zip/Postal code
*Social Security #
*Date of Birth
Are you a US Citizen?
Are you a Kansas Resident?
Are you active-duty military?
Are you a military dependent?
Are you a Veteran?
Do you have a driver's license?
*Are you a current high school student?
High School Last Attended
City State
Graduate?    Year of Graduation 
If you did NOT graduate from high school, do you have a GED?    Year Obtained
           Associate Degree College State: Year:
            Bachelor Degree College State: Year:
            Masters Degree College State: Year:
         Doctorate Degree College State: Year:
       Current or Last Enrollment State: Year:
                          Ethnic Group
*Is this your first On-line Course?  
Are you a first-time college student?
Have you previously
attended NCKTC
If Yes, dates attended (Yr.)
Are you currently enrolled in another college/university?
If Yes, which college/university
Are you transferring from another college/university?
Are you a special student (limited hours)?
Do you plan to earn a degree from NCKTC?
Will you transfer after receiving your degree?
              Father's Education Level
             Mother's Education Level
Why are you interested in taking this course?
*Payment Method


Course Title Cr Hours Instructor
 HE109 Introduction to the Oilfield 3 J. Moeller

Note: All Oilfield courses must be paid for before course enrollment in completed.
Please review the information above and make sure that the information is accurate and up-to-date.

For more information and class registration, please contact Janet Moeller at North Central Kansas Technical College, (785) 738-9013,,

Enrollment will NOT be finalized until payment is received!!

Step 2: Submit this application


Step 3: Pay Online Tuition with PayPal

Online Tuition per Credit Hour

Once this information is submitted it will take at least two business days to process. Please contact the Cashier (1.800.658.4655 ext.003) with payment information as your enrollment will be held until full payment is received.  Online Tuition and fees are non-refundable. You will receive an email acknowledging your completion of the form, full payment and your inclusion into the classes you have selected.


If you are not enrolled into the selected classes you will be notified and further information about when and if you will be able to take the classes will be emailed within two business days of your completion of the form.