LifeskillsLink

Student Registration -Select a Lifeskills Course to Register

Referred by: Education Lifeskills

Agency: ELS Demo

STEP 1 : Select a referral Option

This demo is only for those who have asked or been invited to demo the Education Lifeskills CBT eLearning content.

Step 3: Student Information

First Name*

Last Name*

Email *

Phone number*

Password *

Re enter password*

C/O*

Street*

Apartment Number*

State*

City*

Zip *

Inmate Number*

Floor*

Block*

Cell*

Gender *

Case Number*

Date of birth*

Student number*

Coach name *

Coach email *

Coach cell phone*

Risk level*

Notes*

Set Course Language to Spanish ?*