Spouse Registration

Are you a New Student at ICD? *

Yes

No

Please Type in The COURSE NAME From The Flyer

Zip Code *

Registration

Apartment - If No Apt-put NA *

Please choose the COURSE CREW From The Flyer

A&C

B&D

8 Hour

Student's Name - First, Last *

Spouse's Union Status *

Active Union Member

Retiree

Diversified

Student's Mailing Address - Home or P.O. Box *

Student's Birthday *

Spouse's (Union Member) Name

City & State *

Spouse's Hire Date *

Student's Gender *

Male

Female

If registering for two classes, please complete two registration forms and select first or second choice.

First Choice Class

Second Choice Class

Spouse's Clock Card Number *

Spouse's Department Number *

Student's Phone Number *

Form Submission *

When you click Submit, your registration form is sent to ICD. You will receive an email confirming your enrollment the week prior to the start of the class. Thank You!

Student's Email Address *