Complete this form to register online. NOTE: To send your registration form, you must click the DONE button at the bottom of this page.

* 1. First Name

* 2. Last Name

* 3. Email Address

* 4. Phone 1

* 5. Phone 2

* 6. Mailing Address

* 7. City

* 8. State

* 9. ZIP

* 10. Please indicate your age group:

* 11. When is the best time to contact you?

* 12. Check the academic class(es) you would like to register for:

* 13. Check the vocational class(es) you would like to register for:

* 14. Do you have any barriers that would keep you from coming to class?

* 15. I have child(ren) under the age of 8

* 16. Check your reason(s) for returning to school:

* 17. Have you taken any portion of the GED or HiSET test since 2014 in Pennsylvania?

* 18. How did you learn about Tri-County OIC?

* 19. Please answer: "After I finish my education at OIC, my goal is to..."

* 20. Photo release: "I give my permission and consent to be photographed during OIC activities. I further give permission and consent for OIC to publish and use such photographs to illustrate and promote the OIC experience and programs."

* 21. Enter additional information or questions here.

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