Student Application

Applicant Information

Full Name (required):








Date of Birth (required):

Address (required):







Date Available (required):


Do you have any qualifying disabilities that may require special services? (required):
YesNo

Have you ever attended a related training? (required):
YesNo

If yes, When?

Are you a citizen of the United States? (required):
YesNo

If no, are you authorized to work in the U.S.?
YesNo

Have you ever been convicted of a felony? (required):
YesNo

If yes, Explain:

Education

High School:


Dates Attended


Did you graduate? (required):
YesNo

Trade School/College:


Dates Attended


Did you graduate? (required):
YesNo

Other School:


Dates Attended:


Did you graduate? (required):
YesNo


Previous Employment






Dates Employed:



May we contact your previous supervisor for a reference?
YesNo






Dates Employed:



May we contact your previous supervisor for a reference?
YesNo

Military Service

Dates Served:





Disclaimer and Signature

  • An application fee of $100 is required to submit this application.
  • In order to reserve a seat in a program, a $200 seat deposit is required for each program you are enrolling in for the start date of your choice (all seat deposits are refundable or go towards tuition).
  • If application is cancelled in writing within 3 days of completion, application fee and deposit(s) will be fully refunded.

I certify that my answers are true and complete to the best of my knowledge.