May 2024 Production Workshop Registration

SCCAP Production Workshop

Please join us to make/fabricate/prototype awesome projects and have an opportunity to join one of our Technical Apprenticeship Programs! Start a career in the Aerospace Industry (short application form required to attend). If you have any questions, please contact Jean Paul at (321) 443-3162 or at JPMentortech@gmail.com
Thursday, May 9, 2024 | 10:00am - 4:00 PM

Brevard Adult Education Manufacturing Lab | 1225 Clearlake RoadCocoa, FL 32922
Registration Information
Name*

First NameMiddle NameLast Name
Address*

Street Address

Apartment/Unit #

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
Education
High School: Name of High School*
Address: Street Address*   Address Line 2*   City*   State*   Zip*
From   Date*   to   Date*
Did you graduate?   Yes   No*
Diploma:  Diploma Name*
College: Name of High School
Address: Street Address   Address Line 2   City   State   Zip
From   Date   to   Date
Did you graduate?   Yes   No
Diploma:  Diploma Name
Other: Name of High School
Address: Street Address   Address Line 2   City   State   Zip
From   Date   to   Date
Did you graduate?   Yes   No
Diploma:  Diploma Name
How did you hear about the Workshop?
We'd love to know!*
Photo Release
I hereby grant The Space Coast Consortium Apprenticeship Program and SpaceTec Partners, Inc permission to use my likeness in photograph(s) in any publications or publicity materials (including but not limited to books, newsletters, videos and Web use), in perpetuity. I will make no monetary or other claim against The Space Coast Consortium Apprenticeship Program and SpaceTec Partners, Inc for the use of the photograph(s). If you are under the age of 18 when signing this Photo Release, your parent or legal guardian must also read this Photo Release.
Name*

First NameLast Name
Name of Guardian (if applicant is under the age of 18)

First NameLast Name
Signature*

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Signature of Guardian (if applicant is under the age of 18)

Clear
Signature
Date

MonthDayYear
Date
Signature*

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Name of Guardian (if applicant is under the age of 18)

First NameLast Name
Signature of Guardian (if applicant is under the age of 18)

Clear
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SCCAP Production Workshop

Thursday, May 9, 2024 | 10:00am - 4:00 PM

Registration Information

Education

How did you hear about the Workshop?

Photo Release

Signature