NCCCS Instructor Credentialing Registration
October 26, 2017
CORE 02: Assessment to Instruction: Connection to the Learning Process
Pitt CC, 1986 Pitt Tech Rd, Winterville NC
Training begins at 8:30am and ends at 4:00pm.
Last Name
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First Name
Please no nicknames
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Preferred First Name for Name Tag
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Full name to be printed on certificate
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Provider
Provider (Where you work/volunteer) Please use the full name of the provider with Community College abbreviated with CC and Technical abbreviated Tech. Example: Guilford Tech CC, Stanly CC
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Email Address
Your Community College or Organizational Email Address(Example: sjones@lenoircc.edu or sjones@cravenliteracy.org)
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Confirm Email Address
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Street Address
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City/Town
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State
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Zip Code
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Phone Number
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Cell Phone Number
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Director/Supervisor's Name
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