Pre-Registration Form

Name (First, Middle, Last) *

Date of Birth

Phone Number *

E-mail *

Street Address *

City *

State *

Zip *

County *

Which Open House will you attend? *

Time you will attend *

9 AM
4 PM

Name of Company Who Referred You *

Name of Company or Person Who Referred You

What would you like to study here at Tri-County? *

What is the highest level of education you have completed? *

Bachelor's
Associate's
Postsecondary Certificate (like Cosmetology, Certified Nursing Assistant, etc)
High School (Diploma)
High School (GED)
Middle School
Elementary School
Other

What year did you graduate? *

What year did you complete Grade 8? *

What year did you complete Grade 5? *

Please specify: *

Are you currently working? *

Yes
No

Name of Company

How many hours per week?

What is your job title?

What is your hourly wage?

Where did you hear about the Open House?

Postcard in the mail
Billboard
Social Media
Phone Call from TCTC
School Counselor
Adult Education Teacher or Staff
Other Agency
Other

Which Agency?

Please explain:

Which statement best describes why you are planning to attend the Employment Partnership Open House Event? (Check ALL that apply) *

Need training so I can get a job FAST
Hoping to get some kind of college degree, not sure what
Heard you can get promoted easier with certifications – I am interested in that
Need to get into a program to keep my benefits
Just want to learn about options
Something else

Something else: What?

Have you ever received any financial support (grant, scholarship, loan) to participate in training or a college program? *

Yes
No

Please describe:

Please Solve

Ready to get the TCTC EDGE?

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Ready to get the TCTC EDGE?

Get the Most Out of Your Time at TCTC

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Ready to get the TCTC EDGE?

Get the Most Out of Your Time at TCTC

Ready to get the TCTC EDGE?

Get the Most Out of Your Time at TCTC

Contact Us

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