Registration Form

Section 1: Contact and Record Information

First name ____________________________________

Last name ____________________________________

E-mail _______________________________________

Street address ________________________________

City ________________________________________

State/Province _________________________________

Zip/Postal Code_________________________________

Employer _____________________________________

Day Phone ____________________________________

Evening Phone _________________________________

Soc Sec # _____________________________________

Your Social Security Number is used to create a convenient, unique identifier for your educational record, and to provide information for tax credits and deductions that you may be eligible to claim.  Providing this information is voluntary and will remain confidential.

Section 2: Course Registration Information

Please indicate if class is being taken for (C)redit or (N)on-Credit

Interested in monthly payments? Call 651-450-3578 for information on FACTS, available for many courses.

Payment Options

Section 3: Company payment information

(If you are personally paying for course, skip to section 4)

Contact Name for Billing____________________________

Phone __________________________________________

Email ___________________________________________

Company Name __________________________________

Street Address ___________________________________

City ______________State_______Zip________________

Company Purchase Order # ________________________

(A Purchase Order must be sent to Inver Hills Community

College to complete the registration process. See address below)

Section 4: Personal Payment Options

6 Easy Steps to Register……

 PHONE

Call customized training department at 651-450-3578 and pay with credit card Monday through Friday 8:00 am – 4:30 pm central time.

 FAX

Fax your registration 24 hours a day to 651-450-3883.

E-MAIL

Email to training@inverhills.edu

ONLINE

Visit our website at www.inverhillstraining.org

MAIL

Mail registration to:

Center for Professional & Workforce Development

Inver Hills Community College

2500 80th Street East

Inver Grove Heights, MN 55076

IN PERSON

Visit us at Inver Hills Community College

(The Center for Professional and Workforce Development) in the College Center Building (CC287).