Personal Information * indicates required First Name * Last Name * Home Phone * Cell Phone * Personal Email Address * What is your MEID? * Do you work for a business located in Maricopa County? * Yes No If yes, what is the name of the business? If yes, what is the address of the business? When would you like to start taking classes? * Fall 2024 Spring 2025 Summer 2025 Certificate of Completion – Area of Interest (Select 1) Which CCL are you pursuing? * Accounting Administrative Professional Adobe Animations & Graphics Adobe Audio & Video General Business Entrepreneurial Studies I Entrepreneurial Studies II Management Marketing Microsoft Office Professional Oral Communication Fluency for Non-Native English Speakers Organizational Leadership Social Media Marketing Spanish Language and Culture Understanding & Acknowledgement I acknowledge that I may not add or drop courses without informing my Navigator.* Yes I acknowledge that courses added or dropped without the written approval of my Navigator will be the sole financial responsibility of the student. I also acknowledge that if I drop courses after the MCC Drop Deadline, I will be financially responsible for all related charges.* Yes By clicking submit at the end of this form, I understand and agree to all of the following terms: I understand that participation in CCL training may include career assistance services and that I may be contacted by phone, text and/or email regarding additional educational and career assistance opportunities up to one year after completion of my course of study. I understand that the information I have provided in this questionnaire is correct to the best of my knowledge and I understand that to falsify information is grounds for refusal of services.
