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The Department of Consumer and Business Services, Oregon
Occupational Safety & Health Division (OR-OSHA), in cooperation
with Chemeketa Community College is pleased to offer Continuing
Education Units (CEUs) upon completion of this course.
Postsecondary courses not offered for academic credit
may be measured in CEUs. If you would like to receive
CEUs for the courses you are taking from OR-OSHA, please
fill out the form below. There is a $16 charge for each
class, payable to Chemeketa Community College. If you
have questions, please call (503) 316-3230.
All CEUs are maintained as a permanent record by Chemeketa
Community College. To receive a copy of your transcript,
send a written request to the college registrar.
Please
complete the form below and mail
it with a check to: |
ATTN: Larry Ralphs
Chemeketa Community College TED Center
365 Ferry St. S.E.
Salem, Oregon 97301 |
| Please
make all checks payable to: |
Chemeketa Community College. |
______________________
**Social Security Number |
______________________
Date of Birth |
______________________
OR-OSHA Course # |
______________________
Last Name |
______________________
First Name |
________
M.I. |
_____________________________________________________________________
Mailing Address |
____________________________________________
City |
______________________
Zip Code |
______________________
Daytime Phone |
______________________
Evening Phone |
|
______________________
Check or PO# |
______________________
Visa # |
______________________
Expiration Date |
**CONFIDENTIAL
STUDENT IDENTIFICATION NUMBER: Providing your Social Security
number is voluntary. If you provide it, the college will
use your Social Security for keeping records, doing research,
and reporting. The college will not use your number to
make any decisions directly affecting you or any other
person. Your Social Security number will not be given to
the general public. If you choose not to provide your Social
Security number, you will not be denied any rights as a
student. Providing your Social Security number means that
you consent to use the number in the manner prescribed.
For additional information contact the CCC Admissions Office
at (503) 399-5006.
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