Name: Company:
(First) (Middle Initial) (Last)
Address: City: State: Zip:
Email: Phone: ( ) Secondary Phone: ( )
Where did you hear about this class?
Registration paid by check #:
Registration paid by cash, amount: $ _ Received By:
Refund/Withdrawal Policy
Occasionally, classes may be rescheduled, consolidated or canceled at the discretion of East Central College Business & Industry Center. In the event of a class cancelation by East Central
College Community Education, each student will be provided a full refund. To withdraw, students must contact East Central College Business & Industry Center no less than 48 hours prior to the start of
the class. Students that withdraw less than 48 hours prior to the start of class shall forfeit their right to a refund. Some programs may have specific policies which will be noted in individual class
descriptions. Locations, dates and times are subject to change, but participants will be notified. East Central College does not discriminate on the basis of race, color, religion, national origin, ancestry,
gender, sexual orientation, age, disability, genetic information or veteran status. Inquiries/concerns regarding civil rights compliance as it relates to student programs and services may be directed to
Heath Martin, Vice President of Student Development, 131 Buescher Hall, 1964 Prairie Dell Road, Union, MO 63084, (636) 584-6565 or stnotice@eastcentral.edu.
Revised May 14, 2019
FOR OFFICE USE ONLY:
Registration Date:
Registered By:
Invoice # Roster: _______
Payments Applied –QB’s/Roster________________
In Person:
ECC Business & Industry Center
42 Prairie Dell Plaza Drive
Union, MO 63084
Email to:
training@eastcentral.edu
Mail to:
East Central College
Attn: CWD 1964 Prairie Dell Road
Union, MO 63084
