CNG State Certification Registration Form
|Please indicate which documentation of met prerequisite you are providing.
Prerequisite documentation: (You only need to choose one of the following)
|Note: No certification will be issued until proof of the above prequisites are met.|
|(As it appears on the card)|
|(If different than above)|
To withdrawal from a class, the student must contact Kristi Fields at 682-7894. A full refund will be given for withdrawal prior to the start of class. If you are registered but do not cancel and do not attend, no refund will be issued.
I HAVE READ AND UNDERSTAND THE REFUND POLICY AND MY RESPONSIBLILITES REGARDING THIS ENROLLMENT.
Please PRINT the registration form then submit by MAIL with payment information. You should send a check, money order, P.O. or completed credit card information on the form. You may also fax this form to (405) 682-7549 or email to firstname.lastname@example.org.