Fall Catalog - Cape Girardeau Career And Technology Center
Fall Catalog - Cape Girardeau Career And Technology Center
Fall Catalog - Cape Girardeau Career And Technology Center
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<strong>Cape</strong> <strong>Girardeau</strong><br />
<strong>Career</strong> and <strong>Technology</strong> <strong>Center</strong><br />
Enrollment Form—<br />
Adult Short-Term Classes<br />
<strong>Cape</strong> <strong>Girardeau</strong><br />
<strong>Career</strong> and <strong>Technology</strong> <strong>Center</strong><br />
Enrollment Form—<br />
Adult Short-Term Classes<br />
You must be 18 years of age or older to enroll in courses.<br />
You must be 18 years of age or older to enroll in courses.<br />
To register by mail, enclose a check made payable to “Adult Education”.<br />
Submit a separate check for each course in which you wish to enroll.<br />
CLEARLY PRINT ALL INFORMATION REQUESTED!<br />
Today’s Date<br />
To register by mail, enclose a check made payable to “Adult Education”.<br />
Submit a separate check for each course in which you wish to enroll.<br />
CLEARLY PRINT ALL INFORMATION REQUESTED!<br />
Today’s Date<br />
Social Security Number<br />
Social Security Number<br />
Name<br />
Name<br />
Home Phone Work Phone<br />
Home Phone Work Phone<br />
Home Address<br />
Home Address<br />
City/State/Zip<br />
City/State/Zip<br />
Course Title Session<br />
Course Title Session<br />
Course Title Session<br />
Course Title Session<br />
E-mail Address<br />
E-mail Address<br />
Senior Citizen (55+) YES<br />
Senior Citizen (55+) YES<br />
Charge to Credit Card Number Expiration Date<br />
Charge to Credit Card Number Expiration Date<br />
MasterCard Visa Discover<br />
Registration will NOT be processed, if credit card information is incomplete.<br />
Credit Card<br />
Customers<br />
MUST Sign:<br />
Please Review Refund Policy on Page 5<br />
High School Completed? Yes No<br />
Any medical considerations of which we should be aware? Yes No<br />
MasterCard Visa Discover<br />
Registration will NOT be processed, if credit card information is incomplete.<br />
Credit Card<br />
Customers<br />
MUST Sign:<br />
Please Review Refund Policy on Page 5<br />
High School Completed? Yes No<br />
Any medical considerations of which we should be aware? Yes No<br />
Find us @ www.facebook.com/CAPECTC<br />
This information will be used for statistical reporting purposes only.<br />
This information will be used for statistical reporting purposes only.<br />
Ethnic Description Sex Birthday<br />
White Hispanic Male<br />
Black Oriental Female<br />
Native American Other Month Day Year<br />
Ethnic Description Sex Birthday<br />
White Hispanic Male<br />
Black Oriental Female<br />
Native American Other Month Day Year<br />
<strong>Cape</strong> <strong>Girardeau</strong> <strong>Career</strong> & <strong>Technology</strong> <strong>Center</strong><br />
1080 S. Silver Springs Road • <strong>Cape</strong> <strong>Girardeau</strong>, MO 63703<br />
<strong>Cape</strong> <strong>Girardeau</strong> <strong>Career</strong> & <strong>Technology</strong> <strong>Center</strong><br />
1080 S. Silver Springs Road • <strong>Cape</strong> <strong>Girardeau</strong>, MO 63703
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