Adult Education Registration Form

자바스크립트가 브라우저에서 활성화되어 있지 않아 이 파일을 열 수 없습니다. 활성화하고 새로고침하세요.

Please complete form in its entirety

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Date: *

YYYY

Name: *

Address: *

City/State/Zip *

Home Phone # *

Cell Phone # *

Email address: *

Best phone # for class cancellation or update *

Emergency Contact and Phone # *

Course Name: *

Start Date: *

YYYY

Course Cost: *

Adult Education Registration Policy

* Students are enrolled in the class when payment is received.
* 100% refund if the student requests to cancel their registration 2 weeks prior to the start of class.
* No refund issued after the course begins.
* No refunds for “No Call/No Show” students, regardless of the reason.

I have read and understand the Refund Policy of the Clarion County Career Center Adult Education Program (Application initials below)

Application Initials: *

Official Use Only:

Date Recorded: ________________________ Registration Recorded by: __________________________

( ) Paid in full ( ) Partial payment: Amt paid ___________________ ( ) Cash ( ) Check #: ____________________

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이 설문지는 Clarion County Career Center 내부에서 생성되었습니다. 악용사례 신고

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