Registration Form
Form is now in a PDF format. After reading instructions, please click here to display form and then print it.
1. Give student information on the
form. (If the student is a young child, the parent may complete, print,
and sign the form.)
2. Please do NOT fill the box for office use only.
3. Please indicate the title of course and course date/time for the class you want to
register. A separate registration form must be filled out for each course you want
to register.
4. Send completed registration form and
check made payable to Chipola College.
5. Mail to:
Chipola College
c/o Continuing
Education
3094 Indian Circle
Marianna, Fl. 32446.
6. Or you can bring your completed form and pay at the Continuing Education Office.
7. For more information call Margie Williams at 718-2239 or e-mail at williamsm@chipola.edu.