EKG WCE Registration Form

EKG Registration Form

Office phone: 903-693-2067 email: ce@panola.edu
If Dual Credit Student, please enter high school name.
Name*

First NameLast Name
Student ID if applicable
Date of Birth*

MonthDayYear
MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Ethnicity and Race
YesNo
American Indian or Alaskan NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhite
Special Population Information
NoneDisabledHomelessYouth whose parent is active duty armed forcesSIngle parent, including single pregnant womenEconomically disadvantaged families, including low-income youth and adultsOut-of-workforceYouth in or aged out of foster careIndividual lpreparing for nontraditional fieldBarriers to educational achievment, including limited English proficiency
YesNo
YesNo
Refund Policy

If Panola College cancels a continuing education class, a full tuition refund will be made. A 100% refund will be issued if you drop a class through the approved means of notification during our normal business hours two-(2) business days prior to the first scheduled class day. (Example: If the class is on Monday, notification must be given on the Thursday prior to the start of the Monday class.) No refund will be given after that time. Means of notification include: in writing by e-mail (ce@panola.edu) or in person at Panola College. (There may be some courses for which refunds cannot be made.) Refunds will take several weeks to process and will be mailed to the student’s listed permanent address.
I acknowledge.
Class choices *
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EKG Technician - Spring Session
February 16 - May 28, 2026: Mondays & Thursdays 6:00PM - 9:30PM

$1,128

EKG Technician Dual Credit High School Students
Fall 2026 Day/TIme TBD

$630
You will need to submit a photo or copy of your Drivers License or State ID, High School Diploma / GED Certificate, and your Social Security card.
Please upload a photo of information requested. *

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EKG Registration Form

Ethnicity and Race

Special Population Information

Refund Policy