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CAEC Computer Class Registration
Use this form to register for classes at Conway Adult Education Center's Computer Training Department.
Please note: This form is for entry purposes only. It does NOT guarantee you will be in registered in a class.
You will be notified by phone or email to complete registration.
Date
MM
/
DD
/
YYYY
Enter today's date
Name
*
First
Last
Have you taken classes with us already?
Yes, I have previously registered for a class
No, I have never registered with CAEC
Existing students please indicate best contact information, classes you are interested in and update any information that may have changed since you took a class with us.
What classes are you interested in taking?
You may list current classes offered, or use this area to inquire about classes you are interested in taking.
Please indicate how you would like to be contacted during the day to complete your registration.
Cell Phone
Home Phone
Work Phone
Email
We will contact you with more information before classes start.
Address
Street Address
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Home Phone
###
-
###
-
####
We will use these numbers to contact you for completing your registration. Please be sure to enter at least one form of contact.
Cell Phone
###
-
###
-
####
Email address
We will use this address to contact you for completing your registration.
Confirm email address:
New Student Registration
If you have never taken classes with CAEC Computer Training Department, please take a moment to provide the following information.
Last 4 Digits of SS#
Date of Birth
MM
/
DD
/
YYYY
Birthdate
Sex
Male
Female
Race
White
Black
American Indian
Hispanic
Asian
Other
I am currently
Unemployed
Retired
Self Employed
Employed
Disabled
Name of Business
(if employed)
Work Phone
###
-
###
-
####
If employed, please indicate your salary range
Under 10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
Over $30,000
Please tell us why you are taking this class
To get a job
For current job
To get a better job
Self knowledge/improvement
Other
If you chose other, please briefly explain below.
Other--please explain
Education Level
Less than 12th grade
12th grade or GED
Above 12th grade
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