Registration

To register for access to Metrix Learning, please fill out the fields below.

(Fields marked with a * are required)

First Name: *
Last Name: *
Middle Initial: *
Email Address: *   
Street Address: *
City: *
State: *
Zip: *
Phone: *
Gender:
Employment status: *
Disability Status:
Education: *
Veteran Status:
Served:
If served, service dates: From:     To:  
Rank at discharge:
Referral Source: (e.g. employment services, library, etc.)
 
Would you like to attend a Program Orientation? Yes
No
 
Would you like future communications about the program? Yes
No
Counselor Name: *
Preferred Language:
I have read and understand the Metrix Learning System Policies.
 
(To reduce the amount of spam, please provide the answer to the following question)
Is Ice Hot or Cold?