Program Entry Application
Contact & Basic Info
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Best Contact Number for Call & Text
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Name and Contact Number
Demographics
Gender
*
Female
Male
Non-binary/Third Gender
Prefer to self-describe
Prefer not to answer
Race
*
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Prefer not to answer
Ethnicity
*
Yes, Hispanic or Latino
No, Hispanic or Latino
Prefer not to answer
Veteran Status
*
Yes
No
Prefer not to answer
Disability Status
*
Yes
No
Prefer not to answer
Highest Level of Education / Grade Completed
*
6th grade or below
7th - 12th grade (No Diploma/High School Dropout)
High School Diploma or GED
Some College (No Degree)
Technical or Vocational Certificate
Associate Degree
Bachelor's Degree
Master's Degree
Doctorate or Professional Degree
Screening
Are you legally authorized to work in the U.S.?
*
Yes
No
Are you currently unemployed?
*
Yes
No
Are you dislocated worker?
*
Yes
No
TAP Pathway Selection
Pathways
*
Culinary
Hospitality
Seamanship
Work History
List your 2 most recent jobs
*
Include dates, title, employer name and duties
Barriers & Support Needs
Do you have any barriers or support needs? (Please note, Supportive services are provided based on funding availability and eligibility and are not guaranteed nor an entitlement).
*
Transportation
Childcare
None
Other
Consent & Acknowledgement
Eligibility & Truth Statement
*
I certify that the information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that providing false or misleading information may result in disqualification from the program or termination of participation.
I understand that submission of this application does not guarantee acceptance, nor entitlement into a TAP Culinary Arts, Inc. training program and that eligibility is subject to program requirements, funding availability, and approval by program staff.
Consent to Data Use & Workforce Reporting
*
I authorize TAP Culinary Arts, Inc. to collect, use, and share my information with workforce development boards, funding agencies, training partners, and employers as necessary for program eligibility determination, enrollment, performance reporting, job placement, and compliance with workforce program requirements.
I understand that my information will be handled in accordance with applicable privacy and confidentiality laws.
Program Participation Acknowledgement
*
I understand that participation in training programs requires attendance, completion of coursework, compliance with program policies, and active engagement in employment and placement activities.
I acknowledge that supportive services, certifications, and placement assistance are subject to eligibility and funding availability, are not guaranteed nor an entitlement.
Type a question
*
I authorize TAP Culinary Arts, Inc. to use photographs, video recordings, or other media taken of me during program activities for educational, promotional, reporting, and marketing purposes, including use on websites, social media, reports, and printed materials. I understand that I will not receive compensation for such use and that this authorization is voluntary.
No, I do not consent
Signature
Today's Date
*
-
Month
-
Day
Year
Date
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