Course Member Sign Up

Please fill out and submit the information below to create a course member account.


I'm registering on behalf of my company.
*Email
*First Name
*Last Name
Middle Name
Home Phone
Cell Phone
Social Security (why?)
Address
City
State
Zip

Note: The following information is only used if you are not using the system on behalf of a company.

The following information is used to ensure programs that suit our community's needs. The information will in no way be used to determine eligibility for entrance into programs.

Birthdate
Age
Gender Male Female
Race American Indian
Alaskan National
Hispanic
Asian/Pcific Islander
White (Non-Hispanic)
Black (Non-Hispanic)
Additional Disabled
Displaced Homemaker
Economically Disadvantaged
Single Parent
Educationally Disadvantaged
Limited English Proficiency

Security Question

Security Question
Answer

Passwords must be greater than 6 and less than 25 characters long.

*Password
*Repeat
 



CPI, 540 North Harrison Road, Pleasant Gap, PA 16823 - Telephone: 814-359-2793 1-877-968-7388    (Disclosures)