Continuing Education Registration Form
Last 4 Digits of Social Security Number
Circle Highest Grade Completed
0 1 2 3 4 5 6 7 8
9 10 11 12 13 14 15 16 17
or if High School Equivalency
F Employed Full-Time
P Employed Part-Time
2 Unemployed, not seeking
3 Unemployed, seeking
Name of state
Firefighter, EMS, or Law Enforcement Affiliation
Location of Instruction (Building, Room)
Summer Fall Spring
Class Days (Circle)
M T W T F S
Fax or mail registration form to:
Cleveland Community College
137 South Post Road
Shelby, NC 28152
Call 704-669-4015 to make payment for course(s).
Registration and payment must be received one week prior to the start date
of the class. Office hours are Monday – Thursday from 8 AM – 6 PM and
Friday from 8 AM – 4 PM, excluding holidays and semester breaks.
Continuing Education Refund
The College may refund registration fees under the following circumstances:
1. If a student officially withdraws from the class prior to the first class ses-
sion, the student will receive a 100% refund.
2. If a class is canceled due to insufficient enrollment, the student will
receive a 100% refund.
3. After a class begins and a student officially withdraws from the class
prior to or on the 10% point of the scheduled hours, the student will
receive a 75% refund.
This refund is limited to the registration fee and does not include accident
insurance, liability insurance, textbooks or supplies.