Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Your Mobile Number
*
Format: (000) 000-0000.
Your Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Your County of Residence
*
You must reside in Guilford County to participate.
Your Date of Birth
*
-
Month
-
Day
Year
You must be 18 years or older to participate.
Your Highest Level of Education
*
Please Select
HS (Did Not Graduate)
General Educational Development (GED)
High School Graduate
Terminal Occ Prog/Dipl
Some College (Did Not Graduate)
Associate Degree
Bachelor’s Degree
Master’s Degree
Doctorate Degree
Acceptance into this program requires a high school diploma or GED.
Your current employment status.
*
Please Select
Recently unemployed
Unemployed for more than 27 weeks (6 months)
Underemployed
Employed, looking to transition careers
Employed, hoping to increase skill set
Your marital status
*
Married (not separated)
Separated
Widowed
Divorced
Single
I am motivated to attain a certification because I am… (Choose One)
Unemployed and looking for a long-term career.
Underemployed and searching for a sustaining wage.
Wanting to learn new skills to find a more suitable career.
Hoping to gain new skills and certifications for personal growth.
Hoping to gain new skills and certifications to start a business.
Aspiring to complete a post-secondary degree/certification.
Your career interests (select industry of highest interest)
Advanced Manufacturing
Aviation
Biotechnology
Clean & Renewable Energy
Construction
Electric Vehicles
Healthcare
Industrial Technology
Information Technology
Skilled Trades
Transportation & Logistics
Your career interests (select any that apply)
Aviation
Healthcare
Advanced Manufacturing
Transportation & Logistics
Skilled Trades
Information Technology
Entrepreneurship
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