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ICTC Enrollment Form
To enroll in ICTC courses please complete this enrollment form at least one week prior to course start dates. Submitting this form does not confirm nor guarantee your space in any course(s). Once your enrollment information is received, you will be contacted within 72 hours via email to confirm your enrollment or to let you know that the course is full. You will also receive more information about the course including location, street address, contact name, phone number and directions. A copy of the confirmation email will be sent to your supervisor.

Enrollment is free, however, county agency is responsible for travel expenses. Enrollment is on a space-available basis and limited to the 41 ICTC counties.
Required fields marked in red*
 Personal Information
Salutation Mr. Mrs. Ms. Dr. Other
First name*

MI

 Last name*
Job title
County*
Agency
Daytime phone* Evening phone
Fax number
Email address*
  Yes. Please notify me via email about new courses and special events.
Supervisor name*
Supervisor Phone*
Supervisor email*
 Course Information
This enrollment form is not database-driven, therefore the course information needs to be entered manually for each course you are enrolling in.
 
Course title City Start date
 
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