GEORGIA CAREER INSTITUTE PROSPECTIVE BACKGROUND INFORMATION

Prospective Applicant Background Information (to be completed prior to admissions interview )
GEORGIA CAREER INSTITUTE
900 Flat Shoals Rd SE, Conyers, GA 30094 PH: 770-922-7653 Fax: 770-922-2123
Today's Date

MonthDayYear
Date
Name
email
example@example.com
Address
City
State
Zip
Home Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Date of Birth

MonthDayYear
Date
Are you a US Citizen?
Are you a Veteran?
Will you be requesting approval to transfer hours from a different school? If so, please list how many hours you will be requesting:
Are you currently working Full-time or Part-Time?
Please list your Employer (If you are currently working)
Marital Status:
Please list number of children in household:
Do you have transportation to and from school?
Are you a High school graduate?
What year did you graduate from High School or obtain your GED?
Name of High School (if applicable)
Do you attend any other School/College
Name of School (if applicable)
What year(s) did you attend?
Level or Degree completed:
Do you know anyone who has attended GCI?
If so, please list their name for reference
Which program are you interested in?
When are you thinking about starting GCI?
Have you ever worked in a related field? If so, what field?
Have you ever been convicted of a felony? (All of our programs have state licensure requirements, which may be restricted for certain types of felonies)
How did you hear about GCI
What made you contact us at this time
Why are you thinking about this field as a career
Why would you be a great candidate for study here
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Prospective Applicant Background Information (to be completed prior to admissions interview )

GEORGIA CAREER INSTITUTE