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

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* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. Phone 1

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* 5. Phone 2

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* 6. Mailing Address

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* 7. City

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* 8. State

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* 9. ZIP

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* 10. Please indicate your age group:

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

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

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

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

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

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

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

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

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

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* 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."

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* 21. Enter additional information or questions here.

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