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SIDEZ - Community Planning Workshop Registration Form

Submit your Registration
to Shawnee Community College Online

If you are using a forms-capable web browser, you may fill out the following admission information form for Shawnee Community College. Forms must be filled out completely.

If you have questions, please direct them to: Candy Eastwood
Or phone (618) 634-3231.

Use the "submit" button at the bottom of this page.

* Indicates a required field.

General Information
Please Complete ALL areas of the form.

*PLEASE NOTE: All fields of this form must be completed. If you press submit and have left a field blank, for example your name or address, you will lose your request. To remedy this, hit the back button, and complete the form.

* First Name:
* Last Name:

* Address:

* City:

* State:

* Zip Code:

* Phone:

* e-mail:
Note:If you do not have a valid e-mail address, you cannot complete the admissions process online. To get an e-mail address contact your local Internet Service Provider (ISP), or sign up for a free Yahoo e-mail account by clickling here.

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