Economic Development Division
(Registration Deadline: One week prior to start of course)
Name: Sex: M F Date: __________________
Address: County: ______________________________
City: State: Zip: ________________
Phone: _________________________ Date of Birth: / /
Employer: Business Phone:
CANCELLATION POLICY: You may cancel or reschedule up to one day prior to the course without penalty.
All cancellations received less than one day in advance will NOT be refunded. To cancel a course, please e-mail
email@example.com or firstname.lastname@example.org by 09:00 am the day before the course is to be conducted. NO EXCEPTIONS.
Low Enrollment Policy: We strive to conduct all courses, but low enrollment may require that classes be rescheduled.
Method of Payment (Please check one)
Check # Cash &UHGLW&DUG3URYLGH7HOHSKRQH%HORZ
ll to Contact ,QIRUPDWLRQ: _________________________________________________________________________
Email to the appropriate address below:
Lanier Technical College
Hall Campus - Deal Hall
2535 Lanier Tech Dr.
Gainesville, GA 30507
Lanier Technical College does not discriminate on the basis of race, color, national origin, gender, age or disability. For nondiscrimination information, please contact Nancy Beaver, Title IX Coordinator, Lanier
Technical College, /DQLHU7HFK'U, *DLQHVYLOOH*$, 770-533-7001, or email@example.com and Allison Haynes, Section 504 Coordinator, Lanier Technical College, 2535 Lanier Tech Dr,
Gainesville GA 30507, 770-533-7003, or firstname.lastname@example.org. For more information about our graduation rates, the median debt of students who completed the programs, and other important information please
visit our website at http://www.laniertech.edu/GE.aspx.