Registrant Information |
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First Name: |
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Please review the following errors:
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Last Name: |
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Address: |
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City: |
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Zip: |
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Phone: |
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Alternate Phone: |
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Email: |
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Date of Birth: |
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Taxing School District: |
East Stroudsburg
Stroudsburg
Pocono Mountain
Pleasant Valley
Other
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Course Selection |
Select your Course(s) from the dropdowns below |
Courses will only be held if sufficient enrollment is received by the deadline. If a course is cancelled due to low enrollment, registrants will be notified prior to the first night of class and a refund check will be issued. Registration course fees are not transferable and will only be refunded if your course is cancelled. Please note: Under no circumstances will credit card fees be refunded.
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Demographic Questions |
The following information is requested in order to complete statistical reports which we must file with the PA Dept. of Education. |
Gender: |
Male
Female
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Ethnicity: |
Black
White
Hispanic
Asian
Alaskan / American Indian
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Multiple / No Response
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Special Populations (Check all that apply): |
Displaced Homemaker
Economically Disadvantaged
Educationally Disadvantaged
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Disabled
Limited English Proficiency
Single Parent
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How did you hear about us?: |
Returning Student
Brochure
Career Link
Friends/Family
TV
Radio Station
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Calculated Costs |
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Course Total: |
$0.00 |
Non-Resident Fee: |
$5.00 |
Sub Total: |
$0.00 |
Liability Waiver |
I hereby release Monroe Career & Technical Institute from any and all liability for personal injury or property damage that I may suffer or sustain by reason of use of the school buildings, entrances and exits, the equipment or facilities or as a result of my attendance at Adult Evening School. I understand the course fee will only be refunded if the course is canceled. |
I agree |
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The Monroe Career & Technical Institute is an equal opportunity educational institution |
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