Lifelong Learning Enrollment Form

Please fill out this form to enroll in one of our Lifelong Learning courses.

Name*
Prefix First Last Suffix
Phone*
Email*
Address*
Street Address Address Line 2 (optional) City State ZIP Code
Company
Work Phone
List Class(es)
Please list the name of the class(es) you wish to take. Specify start date(s) if applicable.

For Continuing Education Daytime Classes, please indicate whether you wish to take the class for credit or not. For-credit prices are slightly higher and follow the per credit cost listed in the school catalog.
Name of Class 1*
Class 1 Start Date*
MM slash DD slash YYYY
Taking Class 1 for credit?*
- Yes
- No
Class 2 Details (optional)
Name of Class 2
Class 2 Start Date
MM slash DD slash YYYY
Taking Class 2 for credit?
- Yes
- No
Class 3 Details (optional)
Name of Class 3
Class 3 Start Date
MM slash DD slash YYYY
Taking Class 3 for credit?
- Yes
- No
Students are registered on a "first come, first served" basis. Payment is required to reserve your seat in class. South Hills reserves the right to cancel classes due to lack of enrollment. Call 1-888-282-7427 for more information.

South Hills Professional Development classes are not for credit. Unless specifically requested, Continuing Education classes are not for credit. In these cases, certificates are awarded upon completion.
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List Class(es)