Register

 

. Eastern Westmoreland Career and Technology Center
4904 Route 982, Latrobe, PA  15650-2399

Registrations must be received by Friday, February 17, 2012

Spring 2012Adult Education

 
 

Name _____________________________________________________________Date__________________

 

Address____________________________________City___________________ State ______Zip_________

                                                                                                                       

Day Phone __________________________________EveningPhone _________________________________

 

Course(s) Registering For ________________________________Tuition ____________ Check#_________

 

                                          ________________________________Tuition ____________  Check #_________

 

 

Check here if you are still in high school ______Ifyes, what high school do you attend? __________________

How did you hear of our program?_____________________________________________________________

 

(Make checkpayable to EWCTC and return with this form to address above)

 
 
 
 
 
Day Phone _____________________________Evening Phone _________________________________
 
Course(s) Registering For 
________________________ Tuition ____________    Check #(s) _____________
________________________ Tuition ____________    Check #(s) _____________
________________________ Tuition ____________    Check #(s) _____________
 
Check here if you are still in high school_____  
If yes, what high school do you attend?____________________
How did you hear of our program? ________________________________________________________
 (Make check payable to EWCTC and return with this form to address above)