Continuing Education Registration Form

Please Note: This registration will not be completed until you pay by phone using VISA, MasterCard, Discover or American Express.

Continuing Education Registration Form

Registration

Name(Required)

Student ID (if already enrolled)(Required)

School District (where you reside)(Required)

Other

Email Address(Required)

Mailing Address(Required)

City(Required)

State

Zip Code(Required)

Phone Number(Required)

Date of Birth(Required)

Would you like to receive email updates?

Classes

CRN(Required)

Class Title(Required)

Amount(Required)

CRN

Class Title

Amount

CRN

Class Title

Amount

CRN

Class Title

Amount

Total Amount (add $5 record processing fee)(Required)

Is your employer paying for your course/s?

Students must be 17 years of age or older to take adult learning classes

Please Note: You will not be officially registered for your section until payment is received in full. If you do not call with payment within 24 hours, you will need to complete another registration form. Please phone 610-359-5025 or 610-359-7344 to make payment or if you have questions.

Call 8:30 a.m. to 7 p.m., Monday-Thursday and 8:30 a.m.-5 p.m. Friday
Community Education, 610-359-5025
Workforce Training Programs, 610-359-7344

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