Custom Fit Application Form

Application Form
Company Information:
Company Name:*
Mailing Address:*
City:*
State:*
Zip Code:*
Description of Company:*
# of Full time Employees:*
Company’s Primary Custom Fit Contact:
Contact Name:*
Position:*
Phone #:*
Cell #:
Contact Email:*
example@example.com
Accounts/Payable: UBTech sends all billing invoices via email
A/P Contact Name:*
A/P Email:*
example@example.com
A/P Phone#*
Training Needs: Identify training needed and estimated cost for each
Reason for Training
Example: required for licensing; enhance management skills, etc.
Anticipated Training Needs & Costs:*
Please include # of employees taking training
Industry Sectors*

Aerospace, DefenseAdvanced Mfg/ Food ProcessingComputer Science (Software, IT, Tech)Life Sciences (healthcare, bio-sciences)Regional Target Industry (business activity pursued by economic development organization and its development)ConstructionHospitality, TourismMining & EnergyOther
Company Diversity*

Historically UnderutilizedLGBTQ+ OwnedMinority OwnedNative American OwnedRuralSmall DisadvantagedVeteran OwnedWomen Owned Small
Company Objective*

Company RetentionCompany ExpansionNew Company in Region
How did you hear about Custom Fit?*

Questions?

Contact:

Lezlee Whiting

Custom Fit Senior Officer

UBTech

(435) 725-7109 lezlee@ubtech.edu

Kimberli Wadsworth

Energy Services

UBTech

435.725.7110 kimberliw@ubtech.edu

Lisa Labrum | Custom Fit Administrative

Uintah Basin Technical College

Office: 435.725.7124

Email: lisal@ubtech.edu

Application Form