Child/Teen Registration Form Survey

1.Student Information(Required.)

Child's First Name

Child's Last Name

Child's Date of Birth (mm-dd-yyyy)

2.Please answer the following information based on what you know today.(Required.)

Highest Grade Completed

High School last attended, attending or going to attend.

Anticipated HS graduation date

3.Child's email address (please leave blank if your child does not have their own email.) Having your email will cause an issue in our system, if you ever want to take a class or have taken a class.

4.Parent/Guardian Information(Required.)

First Name

Last Name

Phone Number

Street Address

City

State

Zipcode

5.Confirm your Email Address(Required.)

6.Emergency Contact (someone other than yourself)(Required.)

First Name

Last Name

Phone Number

Relationship

7.Class information(Required.)

Class title

Class number (found in the class description)

8.If you'd like to enroll in additional classes provide titles and class numbers below.

9.Anything else you'd like us to know about your child (e.g. mobility issues etc.)?

10.By filling out this form you are agreeing to be billed for the above classes via mail. (Required.)

I understand.

11.Please Read Carefully

Enrollment Confirmation: You will receive a confirmation email within 3 business days to the parent/guardian email address listed above. Registrations are processed by staff (not automated) so there may be a delay during holidays and school closures. If you haven't received a confirmation within the above stated time from please call us at 608-258-2301, option 2 or email ACE@madisoncollege.edu.

Cancellation Policy: Minimal enrollment requirements must be met to run a class. If a class has insufficient enrollments, it will be cancelled 5–7 days prior to the start date. In the event of a class cancellation, our staff will attempt to reach students using the contact information on file with the school.

Refund Policy: Students are responsible for all tuition and fees unless they drop the class 24 hours prior to the class start date. Refunds will be issued in accordance with the WTCS Refund Policy. If you do not officially drop a class, you will be billed for it even if you do not attend.

Payment Policy: In the event that I fail to timely comply with the payment obligations of Madison College, I agree to pay all collection costs incurred by Madison College.

Waitlists: If a class is full, you will be contacted and have the option to join the Waitlist. If a space becomes available, you will be contacted by our office.

EEO Statement: Madison Area Technical College does not discriminate on the basis of race, color, national origin, sex, disability, or age, in employment, admissions, or its programs or activities.(Required.)

I understand.

12.Demographic Survey: The State of Wisconsin requires Madison College to request the following demographic data to satisfy our State reporting requirements. Your participation is optional. Select all ethnicities the student identifies with (optional)

14.Anyone under the age of 16 needs to complete The Under 16 Registration form.(Required.)

Complete the linked form and upload you form

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