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HOME
ABOUT
Accrediting Agencies
Board of Education
Career Tech System
Employment Opportunities
Faculty
Leadership Team
Partners In Education
Staff
SWTC NEWS
Vision, Mission & Core Values
STUDENT SERVICES
Admission Procedures
Career Guidance
College Credit
CARES Act HEERF Disbursement Report
Educational Enhancement
Financial Aid
Student Billing and Payment Options
Pay Online
School Calendar
Student Policies and Consumer Information
Parent/Student Guide Distance Learning
COURSES
Full Time
Automotive Technology
Aviation Maintenance Technology
Biomedical Science
Business & Computer Technology
Construction
Cosmetology
Health Science Technology
Metal Fabrication
Practical Nursing
Teacher Prep
Short Term
Adult Basic Education
Business & Office Courses
ED2GO
Healthcare Classes
Just 4 Fun
Create Your Own Class!
Motorcycle Safety
Safety Training
BUSINESS DEVELOPMENT CENTER
SWTC Business Development Video
Online Classes/ED2GO
Create Your Own Class!
QUICK LINKS
Events Calendar
Altus Chamber of Commerce
City of Altus
MSDS
Personal Options With Employment Results (POWER)
Search for:
Adult Career Development Enrollment Form
Jill Owenby
2020-06-24T14:21:00-05:00
Adult Career Development Enrollment
First Name:
*
Last Name:
*
MI:
Mailing Address:
*
Street Address
Apt, Suite, Bldg. (optional)
City
State / Province / Region
Postal / Zip Code
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Brazzaville)
Congo
Costa Rica
Cote d\'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor (Timor Timur)
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia, The
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palestinian Territory
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Western Sahara
Western Samoa
Yemen
Zambia
Zimbabwe
Country
Day (work/cell) Telephone:
*
Night (home) Telephone:
*
Email
*
Gender (Male/Female)
*
Last Four of Social Security Number
*
Date of Birth (must be 16yrs or older):
*
Course
*
Certified Nursing Aid
Certified Medical Assistant
Certified Medical Assistant Update
Home Health Deeming
Phlebotomy
Emergency Medical Technician
Motorcycle Safety
Basic Welding
Advanced Welding
CLEET Combo I and II
CLEET III
Other
Education:
*
Less than HS Degree
HS Graduate/ GED
Some college, no degree
Technical Diploma
Associates Degree
Bachelors Degree
Masters Degree
Doctorate Degree
Race:
*
American Indian
African American
Hispanic or Latino
White
Asian
Prefer to Not Answer
Please Check All
*
I acknowledge that I must officially withdraw prior to the second class meeting for a refund. Refunds are tuition on minus $25.00 processing fee. If I withdraw before the course starts a full refund (tuition only) will be processed. Books are not refundable.
I understand that if I am paying by check that if it is returned for any reason there is a bank fee added to the amount of the check. All returned checks plus the bank fee must be paid in cash.
I understand that Southwest Technology Center will notify me if a class is cancelled or postponed at the above numbers(s).
Would you pay a higher tuition fee if a class enrollment is lower than require to cover the instructor cost so the class can still start as scheduled?
*
The additional fee would be divided between the students enrolled.
Yes
No
Signature
*
Today's Date
*
Please Note:
NO CERTIFICATION WILL BE ISSUED FOR LESS THAN 75% ATTENDANCE IN CLASS!
FOR OFFICE USE ONLY
Receipt Number:
Book Received
Amount Paid:
Payment Type
Check
Cash
Credit Card
Money Order
Payment Received By:
Self Pay or Reimbursement
Self Pay
Company Pay or Reimbursed
Statement of Non-Discrimination
Southwest Technology Center does not discriminate on the basis of race, color, national origin, sex/gender, age, disability, or veteran status in admission to its programs, services, or activities, in access to them, in treatment of individuals, or in any aspect of their operations. Southwest Technology Center does not discriminate in its hiring or employment practices. This notice is provided as required by Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, Title IX of the Education Amendment of 1972, the Age Discrimination Act of 1975, and the Americans with Disabilities Act of 1990. Questions, complaints, or requests for additional information regarding these laws may be forwarded to Compliance Coordinators RaChel Crume and Kerry Evans 711 West Tamarack Road Altus, OK 73521 (580)477-2250 each weekday from 8:00 a.m. to noon and 1:00 p.m. to 4:00 p.m.
Verification
Please enter any two digits
*
Example: 12
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