REGISTRATION

To register for Adult Education programs:

• Search our programs and course offerings by following the links to the left and find the right course(s) for you;

• You may print and complete the registration information at the bottom of this page, download our catalog to the left and complete the registration information, or click here to download a registration form (MS Word file);

• Use one of the five methods listed below to complete registration: Walk-in,      E-mail, Phone, Fax, or Mail. The downloadable form includes these registration methods and contact information.

WALK-IN:

Mon.-Thurs. 10am-9pm.

Bring the registration form with your check, cash, VISA or MasterCard

E-MAIL:

pl_adult@portagelakescareercenter.org

BY PHONE:

330-896-8200            

Mon.-Thurs. 10am-9pm You may register by phone using your VISA or MasterCard

BY FAX:

330-896-8297

Fax your registration form 24 hours a day  

BY MAIL - Send the completed registration form with payment to:

Portage Lakes Career Center - Adult Education Department

P. O. Box 248

Green, OH 44232-0248

REGISTRATION INFORMATION

Please Print

Last Name(s)_____________________  First Name(s)______________________

Street Address_______________________________________________________

_____________________________________________________________________

 City_______________________________  Zip____________

Phone (day)__________________Phone (evening)______________________

E-Mail_____________________________________________________________

Course name/date/time___________________________________

Additional course name/date/time___________________________

Additional course name/date/time___________________________

Please make checks payable to Portage Lakes Career Center:

Check Amount $_________________ Check #________________

Please bill my: VISA/MasterCard #__________________________

Card Code (CVV2)______________ Exp. Date_______________

 Company Name, complete address and P. O. No. _____________________________________________________________

_____________________________________________________________

Signature: _____________________________________________

*NOTE: We do not accept Discover.

We will not be responsible for the confidentiality of any personal or credit card information transmitted via e-mail.