Course Registration Form

Name:
  Last First MI
Address:
Phone Number:
Email Address:
Name of Course(s): Please LIST course(s) For which you wish to register.
 
 
 
 
 
Do you wish to take this course for credit or for personal enrichment (non-credit)?
Are you currently enrolled in a Consortium college or university?
If yes, which one?

This registration insures your slot in the course(s) you have chosen. Close to the start date of the course(s) you will receive a college/university course registration and an invoice. Please return to:

Jeanette Schnars
Director,
Regional Science Consortium
Tom Ridge Environmental Center, Suite 9
301 Peninsula Drive
Erie, PA 16505 or
jeanette@RegSciConsort.com

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Regional Science Consortium, 301 Peninsula Dr., Suite 9, Erie, PA 16505 (814) 835-6975

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