CCC Workforce Development Registration Form
Date
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Name (Last, First, MI)
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Address (Street)
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City, State
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Zip Code
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Phone
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Email
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Birthdate
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Social Security # (xxx-xx-xxxx)
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How did you hear about our program?
Course #
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Course Title
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Course Start Date
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Course Start Time
Time
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Course #
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Course Title
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Course Start Date
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DD
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YYYY
Course Start Time
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Please enter you check the box to show that you understand entering your name constitutes a legal signature confirming that you acknowledge and accept the terms of registration.
Please type your legal name below this will serve as your digital signature:
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Cancellations and refunds:
Non-Allied Health Cancellations: Cancellations must be made 5 business days prior to the first day of class to receive a refund of the course price, less a $10.00 processing fee. After that time, there are no refunds. If a last minute cancellation occurs, we suggest you send someone in your place. Cumberland County College makes no guarantee that all scheduled classes will run. Classes may be canceled due to low enrollment whether scheduled at the Vineland campus or any off site location.

Allied Health Care Refund Policy: 100% Refund for withdrawals before first day of class. 50% refund for withdrawals during the first week. No refunds after the first week.

Questions???
If you have further questions or need help with course information or costs, please call 856-378-7883 and someone will be happy to assist you.
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