Your Mailing and Physical Address

If your physical address is the same as your mailing address, leave the physical address blank

THE FOLLOWING INFORMATION IS OPTIONAL

HOWEVER IT WILL BE BENEFICIAL IN DETERMINING YOUR NEEDS FOR ASSISTANCE

EMERGENCY SERVICE PERSONNEL ONLY

MOTORCYCLE SAFETY COURSE ONLY

If you are under 18 years of age, DO NOT register on-line. You must register at McDowell Technical Community College with a parent present

DEFENSIVE DRIVING COURSES ONLY

Please Note: All Defensive Driving Courses are self-supporting classes and the registration fee is non-refundable. Refunds are made only if the class does not make. Students that do not show up for the class on the date they are registered will need to complete the registration process again (including registration fee) for the next available class. By completing the remainder of the form and signing at the end, I acknowledge that I understand all the information above.

PHLEBOTOMY, HEALTHCARE BILLING & CODING ONLY

Certification of Accuracy

By submitting this online registration form, I certify to the best of my knowledge that the information given is true and complete. Further, I understand and agree that my electronic signature is the legal equivalent of my manual signature. I certify to the best of my knowledge that the information given is true and complete. Further, I understand that by submitting this information via electronic transmission that I acknowledge the following: I do not have any outstanding balances with McDowell Technical Community College. I understand that I cannot register into a class that meets at the same time of another MTCC class for which I am registered. I understand that if I falsify any information on the demographics information above, or on any future registration forms, my certification will be eliminated. I understand and agree that my electronic signature is the legal equivalent of my manual signature. Permission is granted to release appropriate course information to certifying agencies.

* By submitting this form I acknowledge that the above typed name is my signature

Once you submit this form, someone from the Continuing Education and Workforce Development Department will contact you for further instructions.

Thank you for Registering for classes at McDowell Technical Community College. We are delighted to serve you.