S.C.O.P.E. : Grassroots Training Program enrollment form

Grassroots Training Program enrollment form

Please fill out the form below.

* First Name

* Last Name

* Phone

Cell Phone

* Street

* City

* State

* Zip

How would you classify your computer's skills?
Basic
Intermediate
Advanced

Do you have a computer at home?
Yes
No

Can you commit to attend to the following 6 classes from 6pm - 8pm?
Tuesday - 04/12/11
Tuesday - 04/19/11
Tuesday - 04/26/11
Thursday - 04/28/11
Tuesday - 05/03/11
Thursday - 05/05/11
Yes
No

Additional Comments:

First Name

* Required Field