PCC Open House

Questions marked with * are required.

Personal Email Address (please avoid using a high school address)

Personal Email Confirmation (re-enter email address)

First Name

Last Name

Preferred Name (Optional)

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Mobile Phone Number

Can we send text messages to this phone number?

Yes

No

When do you plan to start at PCC?

What program are you interested in?

Are you currently attending high school?

Yes

No