Mail to: CTC – Career Technology Center
3201 Rockwell Ave., Scranton, PA 18508
3201 Rockwell Ave., Scranton, PA 18508
Student Applicants MUST be at least 18 years of Age
Social Security Number – This is your student ID Number Birthdate
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Last Name First Name MI
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Street/Mail Address
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City State zip Code
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Area Home Phone Area Business Phone
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___________________________________________________________________
| Receipt Number: | Check Number: | ||||
| Course Title | Number | Fee | Total | ||
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Subtotal | $ | ||||
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Less Deposit Paid with Application (At least ½ of course fee) | - | ||||
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Balance Due after Deposit | $ | ||||


