PA Emissions Course Application 2026-2027

PA Emissions Course Application

2026-2027
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
Date of Birth
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
School DIstrict of Residence
For example: Reading School District
Have you ever attended a K-12 School in Pennsylvania?
Do you currently hold a valid PA Driver's License?
Please enter your eight-digit PA Driver's License number:
Valid PA License required for PA Emissions Certification
What ethnicity are you?
Each emissions course consists of two evening classes (5:30 pm - 9:30 pm).

PA Safety Emissions Course Fee: $80.00

The following additional fees will be applied for each category tested:

An additional fee of $39.99 for study materials and exams must be paid to PennDOT via their website, www.patrainingportal.com, a minimum of 3 days prior to the beginning of class.
September Course Dates:
Tues., Sept. 29, '26 - 5:30-9:30pm
Thur., Oct. 1, '26 - 5:30-9:30pm
Which course do you select?

RMCTC PA Emissions Course (Credit Card)

$80.00

RMCTC PA Emissions Course (Cash Option - NOT FREE)

Cash Option - NOT FREE - is marked as zero on this application. The full amount of $80 is to be paid, in cash, on the first night of class.

Free

RETEST - PA Emissions Certification

$40.00

Total

Please indicate any comments, concerns, special requests or accommodations below.
Should be Empty:

PA Emissions Course Application