Training Information Request
Center for Workforce Development

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

CWD Class : (Please type in either the course name or course id)

Signature and Statement Understanding

It is the policy of San Juan College not to discriminate on the basis of sex, disability, race, color, religion, or national or ethnic origin in its admission policy, financial aid, or other school administered programs. This policy is enforced by federal law under the Title IX of the Education Amendments of 1972, Title VI of the Civil Rights Act of 1964, and Section 504 of the Rehabilitation Act of 1973. Additionally, SJC grants the same tuition or state-funded financial aid to all persons in compliance with SB 582 (2005).

I AUTHORIZE San Juan College [including Center for Workforce Development (CWD) to release the above
information to my employer (or potential employer), AND I release San Juan College from any future liability
related to the release of this information

Signature of Applicant *

clear

Training Information Request Center for Workforce Development

Training Information Request
Center for Workforce Development