Form is now in a PDF format. After reading instructions, please click here to display form and then print it.
Simple Steps for Registration
Complete student information on the form. (If the student is a young child, the parent may complete, print,
and sign the form.)
Do NOT fill the box for office use only.
Indicate the title of course and course date/time for the class you want to register. A separate registration form must be filled out for each course you want to register.
Send completed registration form and check made payable to Chipola College.
c/o Continuing Education
3094 Indian Circle
Marianna, Fl. 32446.
Or bring your completed form and pay at the Continuing Education Center.
For more information call 850-718-2405 or email firstname.lastname@example.org.