Student Application
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Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Are you any of the following?
*
Please Select
Veteran
Injured Veteran
Injured on Workman's Comp
Client of the State Dept. of Rehabilitation?
TAA Training Eligible?
Receiving Unemployment?
Which Training Department would be of interest?
Auto Mechanics
Maintenance Technician
Industrial Refrigeration
Welding
HVAC
How soon would you like to start school?
As soon as possible
Within 30 days
Within 60 days
Submit
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