Your College Name Here

Camden County College

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COURSE SELECTION

Please select a course you would like to attend. If you are interested in attending a class that is no longer visible on this form, please call 856-227-7200 Ext. 4048 or e-mail: customizedtraining@camdencc.edu to determine if there is a waiting list or the class is cancelled. An email confirmation will be sent prior to the class. For course descriptions, click here .

Courses *

Supervisory Skills for the New Supervisor, 6/20/19, 8:30am to 3:00pm, Rohrer Center, 1889 Route 70 East, Cherry Hill NJ* Supervisory Skills for the New Supervisor*6/20/19*6/20/19*8*Camden County College*Open Problem Solving - Dealing with Difficult People, 6/27/19, 8:30am to 5:00pm, Rohrer Center, 1889 Route 70 East, Cherry Hill NJ* Problem Solving - Dealing with Difficult People*6/27/19*6/27/19*8*Camden County College*Open Excel II (2016), 7/10/19, 8:30am to 5:00pm, Rohrer Center, 1889 Route 70 East, Cherry Hill NJ* Excel II (2016)*7/10/19*7/10/19*8*Camden County College*Open Emotional Intelligence, 7/11/19, 8:30am to 5:00pm, Rohrer Center, 1889 Route 70 East, Cherry Hill NJ* Emotional Intelligence*7/11/19*7/11/19*8*Camden County College*Open The Extraordinary Leader, 7/16/19, 8:30am to 5:00pm, Rohrer Center, 1889 Route 70 East, Cherry Hill NJ* The Extraordinary Leader*7/16/19*7/16/19*8*Camden County College*Open Time Management Boot Camp, 7/31/19, 8:30am to 5:00pm, Rohrer Center, 1889 Route 70 East, Cherry Hill NJ* Time Management Boot Camp*7/31/19*7/31/19*8*Camden County College*Open For Camden County College Use Only

YOUR PERSONAL INFORMATION

First Name *

Last Name *

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Date of Birth

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Job Title *

Your Address

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Your Wage Code *

A=$10/hour or less B=$11-$15/hour C=$16-$20/hour D=$21-$24/hour E=$25/hour or above

Ethnicity

Asian American/Asian/Pacific Islander Black/African American/African Hispanic/Latino/Chicano/Spanish Native American/American Indian/Alaska Native White/Caucasian/European

EMPLOYER NAME & ADDRESS

Employer Name *

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DUNS Number

Street Address *

City *

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Manager"s E-Mail Address

Manager"s Phone Number

ELECTRONIC SIGNATURE

Please read carefully and sign below.

The following statement is in accordance with the Higher Education Act. I grant permission to the College and NJ Community College Consortium for Workforce & Economic Development & Member Colleges to share information including the transfer of grades, credits, and other academic records, where applicable, among other organizations and/or agencies/businesses that provide funding for this training. I have secured my employer"s approval for attending this course in accordance with the company policy and NJ Department of Labor (funding agency) regulations. College Cancellation Policy: If I am unable to attend the class I registered for, I must notify the College at least seven business days prior to the class date. I understand that if I do not cancel within this time period, my employer or I may incur a $100 cancellation fee. I understand that I have the option to send an eligible participant to attend the class in my place. I will contact the College with the replacement"s contact information within 48 hours before the class date.

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