All confidential information is for accounting purposes only






 American Indian or Alaska Native
 Asian
 Black or African American
 Native Hawaiian or Other Pacific Islander
 White
 Unknown

 Hispanic
 Not Hispanic
 Male
 Female
 Yes
 No
  Less than a High School Diploma
  High School Graduate/GED
  Some college , No Degree
  Technical Diploma
  Associate Degree
  Bachelors Degree
  Masters Degree
  Doctorate Degree
  Yes
  No

By Checking the box below I grant permission for Kiamichi Technology Center | Atoka staff to release pictures and information about my participation in their programs and activities to the local area press for publication and on Kiamichi Technology Center | Atoka Tech promotional materials, social media, website and BIS newsletter.

 I agree to the above permissions

BY SIGNING BELOW, I UNDERSTAND IT IS KIAMICHI TECHNOLOGY CENTER'S POLICY THAT STUDENTS ARE NOT ELIGIBLE FOR A TUITION REFUND AFTER THEY ATTEND ONE(1) HOUR OF TRAINING.

 I agree to the above permissions

 Unsubscribe me from further emails