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Continuing Education Class
Pre-Registration Form

*First Name: 

*Last Name:

*Address 1:

Address 2:

*City:  

State:     Zip:  

*Phone:    

*Email:

Company Name: 

Please enter the class(s) names you would like to register to attend below:

Class #1:

Class #2:

Class #3:

Class #4:

Please enter any additional information or questions below.

You will receive an e-mail confirmation within 3 business days
 from Continuing Education.
This registration will hold a space for you in the selected class(es) for 1 week.
The Division of Continuing Education requires payment in advance for all classes.

Please make your check payable and mail with printed form to:

Clarion University
Continuing Education
840 Wood Street
Clarion, PA  16214

Questions?: (814) 393-2227 or continuinged@clarion.edu

Check here, if you prefer to pay with a credit card,
and someone from our office will call you. 

We can accept Visa, MasterCard and Discover over the telephone.

Please Print this form for your records before hitting the Send button.