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Recovery College Registration
Register for Recovery College Courses
for more information about these courses.
Recovery College Registration Form
I want to:
Register myself as a student
Register on behalf of a student (referral)
I am 18 years old and older
I am 16 or 17 years old (you will be provided with a consent form that must be signed by your parent and/or guardian)
Student age (if you are registering on behalf of the student):
I have permission from the student to enroll them into Recovery College
The student is 18 years old and older
The student is 16 or 17 years old (you will be provided with a consent form that must be signed by the student’s parent and/or guardian)
New or returning student to recovery College
OK to leave a phone message?
Best time(s) of day to call:
Other time to call
Courses Interested In (Please Fill In):
(e.g. Art of Friendship, Friday's 10am - 12pm, January 12 - March 2)
Professional Referral / Support Person
Fill out this section if you are referring a student
a professional referring a student
a support person (family member, friend, etc.) referring a student
Note: A Recovery College representative will connect with the student directly.
Check here if you would like to get a receipt of confirmation via email
Position Title / Profession
Relationship / Connection to Student
Organization / Agency
Why are you registering this student?
This field is for validation purposes and should be left unchanged.