Employee Registration Form

Personal Information

The purpose of registering with the Maine Community College System's Harold Alfond Center for the Advancement of Maine's Workforce is to collect data required for grant reporting. Your data is anonymized for this purpose.

Please note: You will also need to register with the training vendor for this training as well.

First Name

*

Middle Name

Last Name

*

Maiden/Birth/Other Name: (if applicable)

Suffix

Date of Birth

*

Social Security Number (optional)

Email Address

*

Confirm Email Address

Please provide either a Home OR Mobile phone number

Home Phone

*

Cell Phone

*

Permanent Mailing Address

Please enter your home address and not your company’s address.

Line 1

*

Line 2

City

*

State

*

Zip

*

Additional Information

Please select the gender with which you most identify:

*

Are you Hispanic/Latino?

Race (Select one or more):

1.

White

2.

Native Hawaiian or Other Pacific Islander

3.

Black or African American

4.

Asian

5.

American Indian or Alaska Native

Education (highest completed):

*

By clicking Submit, you acknowledge the following:

- Proof of COVID-19 vaccination is required for all students and trainees who enter Maine Community College campus buildings in accordance with MCCS's COVID-19 vaccination policies.

- You are giving us permission to release your educational records, including registration and completion results, to your employer.

HAF Student Registration