Camden County College

Ref #

College Name

Consortium Class Title

Welcome to our Workplace Literacy and Basic Skills Training registration! We're thrilled to have you on board. Follow these simple steps to enroll in our free classes:

1. Select an online course from the exciting options available.

2. Complete the registration form by providing your personal information and employer details.

3. Click "Submit" to secure your spot.

Eager for more learning opportunities? Fantastic! Repeat the process for each additional class you'd like to attend.

An email will be sent 1-2 days before each class, providing final details, including a Zoom link. For detailed course descriptions, click here.

For any questions or assistance, reach out to us at customizedtraining@camdencc.edu

Courses:*

YOUR PERSONAL INFORMATION

Fields marked with red asterisk (*) are mandatory.

First Name*

Last Name*

Your Email*

Your Phone Number*

Legal Sex

FemaleMaleX or another legal sex

Are you Hispanic or Latino/a/x ?

YesNo

Regardless of your answer to the prior question, please indicate how you identify yourself (select one or more)

Job Title*

Your Wage Code*

Date of Birth

Your Address

Your City

Your State

Your ZIP

EMPLOYER NAME & ADDRESS

Employer Name*

Federal Employer ID Number*

DUNS Number

Street Address*

City*

State*

Zip Code*

County*

Manager's E-Mail Address*

Manager's Phone Number*

ELECTRONIC SIGNATURE

Please read carefully and sign below.

The following statement is in accordance with the Higher Education Act. I grant permission to the College and NJ Community College Consortium for Workforce & Economic Development & Member Colleges to share information including the transfer of grades, credits, and other academic records, where applicable, among other organizations and/or agencies/businesses that provide funding for this training. I have secured my employer"s approval for attending this course in accordance with the company policy and NJ Department of Labor (funding agency) regulations. College Cancellation Policy: If I am unable to attend the class I registered for, I must notify the College at least seven business days prior to the class date. I understand that if I do not cancel within this time period, my employer or I may incur a $100 cancellation fee. I understand that I have the option to send an eligible participant to attend the class in my place. I will contact the College with the replacement's contact information within 48 hours before the class date.

Your Initials*

Date:

CAMDEN COUNTY COLLEGE