First Name:		Last Name:
Company Name:
Title:
Street Address:		City:
State:		Zip:
EMail Address:
Phone:
Date of Birth:
Race:	Select One White Black or African American Hispanic Non-Hispanic American Indian or Alaskan Native Native Hawaiian or Pacific Islander Other/Unknown

If the person completing the form is different than the person that will register for the training please list their name, email, phone, race and DOB.

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	Please select from the list below your training category. You can select more than one. Cost is $50/Module. If you want to customize your training please contact Cynthia.brown@chattahoocheetech.edu for assistance.
	Each group below has multiple modules that make up that complete training. Once you select your area of interest we can email you the course outline.

Programs		Virtual Trainers
Custom		Electric Motor Control (85-MT5)
Industry 4.0 Fundamentals		Measurement Tools 1 (950-MES1)
Automation		Production Assembly (950-PAS1)
Electronics		Split Flange Coupling Assembly (95-PAS2)
Electrical		Electric Torque Wrench Assembly (95-PAS3)
Fluid Power		Mastering Programmable Controllers (A-B CompactLogix L16) (990-PABCL1F)
Green Technology		AC/DC Electrical Systems (T7017A)
Lean Manufacturing		Electrical Control 1 (96-ECS1)
Machining		Machine Tools 1 (96-MP1)
Manufacturing Process		Mechanical Systems (96-MEC1)
Materials		Basic Pneumatics (96-PNE1/85-BP)
Mechanical		Basic Hydraulics (85-BH)
Process Control
Quality Assurance
Safety
Thermal
Workplace Effectiveness

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