Registration Form

Central Westmoreland Career and Technology Center

Evening School Class

Spring 2007 Semester

Registration begins January 2, 2007

Name_______________________________________________________________   Date ___________

Address _______________________________________City _______________________ Zip_________

Home Phone _____________ Cell Phone ______________ Email ________________________________

Place of employment _______________________________________  Daytime phone ________________

Highest grade completed: Elem: 1 2 3 4 5 6 7 8 H. S. 1 2 3 4 College 1 2 3 4

Course(s) registering for:___________________________________________________Cost __________

______________________________________________________________________Cost __________

_____________________________________________________________________Cost ___________

 

My reason for taking this course is:

Job preparation ____Upgrading present work skills ____Personal Interest ____

My vocational/career objective is: ____________________________________

 

My payment of $________________enclosed

Payment must be made payable to Central Westmoreland Career and Technology Center

Return form and payment to: 

Attn: Coordinator, Business & Industry

Central Westmoreland Career and Technology Center

240 Arona Road

New Stanton, PA  15672