CREED - Hampton Roads Virginia (HRVA) Interest Form

CREED - Hampton Roads Virginia (HRVA) Interest Form
We are excited for you to join us for the CREED-HRVA Training in Norfolk. This training has three parts:
- October 20-21: BPI Building Science Principles (BSP) Training
- October 22-23: OSHA10 and NFPA70e Certifications
- October 26-30: NABCEP PV (Solar) Associate Exam
The training sessions will be held at: Centura College, 7020 N. Military Highway, Norfolk, VA 23518
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Participants in CREED-HRVA must be at least 18 years old. Please select your Date of Birth

MonthDayYear
Please SELECT ALL PARTS of this 3-part training you would like to attend.
Do you need supportive services in order to attend the training? (select all that are needed)

Other
If you answered Other above, please specify the supportive service that you need to attend the training.
What is your current housing situation?
Are you justice-impacted or currently under supervision?
Level of Education
Gender
Are you a US citizen?
Have you ever served in the US military on active duty for more than 180 days?
What form of identification do you have?

Other
Are you currently employed?
Are you currently registered with any workforce agency in the State of Virginia ?
How did you hear about us?

Other
Additional Comments:
By signing, I attest that all information I have provided is true and complete to the best of my knowledge. I agree to attend the in-person CREED-HRVA project, that being held at Centura College, 7020 N Military Hwy, Norfolk, VA, 23518. I will be respectful to the class and instructor at all times.
Signature
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