Registration Form

  • Online payment is temporarily unavailable. After submission, CALL 205-856-7710 to arrange payment via mail or delivery to Campus. Payment cannot be accepted over the phone. Registrations are not complete until payment is received.

  • Course Registration Information:

  • Fast Track Career Programs Only:

  • By clicking the boxes below, you are agreeing to the following statements.

    Board requirements can be reviewed at: www.albop.com/PharmacyTechnician.aspx
  • On Site Course Refund/Withdrawal Policy

    • To withdraw and receive a refund after registering, students must submit a completed “Withdrawal Form” to the Center for Workforce Development at least ten business days in advance of the first day of class. Refunds are less an Administrative Fee of five percent (5%) of the refund amount.
    • Students who register less than ten business days prior to the first of class waive their right to a refund except for insufficient enrollment.
    • If classes are postponed by Jefferson State, students may withdraw for up to 5 business days and receive a full refund. Student who withdraw after 5 days in the case of a postponement, waive their rights to a refund.
    • I understand I am not registered for class until payment is received by Jefferson State Community College. I will be contacted via the email address provided with additional instructions to complete my registration process.

    For complete policies click here.

  • Type your name and date as your student signature.