Continuing Education Registration Form

Form is now in a PDF format. After reading instructions, please click here to display form and then print it.

1. Give student information on the form.  (If the student is a young child, the parent may complete, print,
    and sign the form.)
2. Please do NOT fill the box for office use only.
3. Please 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.
4. Send completed registration form and check made payable to Chipola College.
5. Mail to: 
            Chipola College
            c/o Continuing Education
            3094 Indian Circle
            Marianna, Fl. 32446.
6. Or you can bring your completed form and pay at the Continuing Education Office.
7. For more information call Janet Wise at 718-2395 or e-mail at  wisej@chipola.edu.

Back to Continuing Education
Last updated on: March 10, 2006