Student Enrollment Form
Name
*
First Name
Last Name
S.S #
*
Required for Mi-Work Grant Funding
Race Diversity
*
Please Select
African American
Caucasian
Asian
Indian
Hispanic
Other
Required for Mi-Work Grant Tracking
Date of Birth
*
Required for Mi-Work Grant Funding
Age Group Diversity
*
Please Select
Under 18
18 - 25 years old
26 - 35 years old
36 - 45 years old
46 - 55 years old
older that 55 years old
How did you hear about our program?
What motivates or attract you to enroll in the GSHA courses? (Select all that apply)
6 to 8 week short duration apprenticeship program
Online learning with videos & interactive exercises
Self-mastery classes to become the world's expert on myself
Part-time weekly commitment that is completed at your own pace
Anyone can enroll. No special education, experience, or connections needed.
Career opportunity with job placement and wages
Financial wellness program to show you how to make money and save money.
Mentor and support services with courses and on the job
Other
Which GSHA training program interest you for enrollment
Six Sigma Green Belt (process improvement)
Quality Control (Inspecting, sorting, auditing to verify product meet requirements)
Manufacturing (product assembly or fabrication)
Material Logistics (packers or mover of material)
Can we contact you for the next steps to enroll in the program?
Yes (within the next 30 days)
No
Later (3 to 6 months)
Email
example@example.com
Phone Number
Please enter a valid phone number.
Submit
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