3 Week Training Application

3 Week Training Application

Schmidt Training and Technology Center: Industrial Machine Operator Program and Industrial Maintenance Helper Program
Date Submitted *

Month Day Year
Date Hour Minutes AM/PM Option
Name *

First Name Last Name
Address *

Street Address

Apartment/Unit#

City State

Zip Code
Phone Number

Area Code Phone Number
Email *
example@example.com
Date of Birth *

Month Day Year
Date
Which program are you interested in? *

Industrial Machine Operator Program Industrial Maintenance Helper Program
This course requires mechanical experience (experience is not required to be job related). Please list hand and power tools you have experience with.
List tools here.
Have you ever worked in a manufacturing environment?

Yes No
If yes, when and where?
Are you currently employed?

Yes No
If yes, name of employer.

Education