Short-Term Training: Welding Registration

Name

First NameMiddle NameLast Name

Employer

Share where you work if you're registering for this training at your employer's request.

Have you attended Mid before?

If yes, what was your name when you previously enrolled?

Please only enter a response if your name is different now.

Date of Birth

MonthDayYear

Sex Assigned at Birth

Gender Identity

Race

Race | Select all that apply.

Last Four Digits of Social Security Number

Enter the last four digits of your social security number.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Mobile Number

Area CodePhone Number

Email

Enter the name of the high school you graduated from.

Enter the year you graduated high school.

How did you hear about us?

View upcoming Welding Short-Term Trainings to select your preferred training location and start date.

Select your preferred training location.

Enter your preferred training start date.

Since you'll be training in Bad Axe, select the type of welding you are interested in.

Welding Coat Size

Choose S, M, L, XL, or XXL.

Welding Glove Size

Choose S, M, or L.

Emergency Contact Name

First NameLast Name

Emergency Contact Relation

Other

Emergency Contact Phone Number

Area CodePhone Number

How will you pay?

Other

All welding students 18 years of age and older are required to pass a background check. Criminal background records of felonies and certain misdemeanors may affect eligibility for the College's Welding Short-Term Training. I understand that Mid Michigan College may obtain and review conviction criminal history information for my participation in Welding Short-Term Training. This ensures eligibility but does not guarantee employment upon completion. By selecting that I agree, I release the following information and consent to its use for this purpose.

By registering for this training, you are granting Mid Michigan College permission to share your personal information with State and Federal reporting and funding agencies.

Both of the above statements must be understood and consented to in order to pre-register for this training. If you have questions, call (989) 386-6614 for assistance.

Signature

Today's Date

MonthDayYear

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In its commitment to providing a safe environment, Mid Michigan College actively endeavors to broaden our diversity, promote equal opportunity, and prohibit any form of discrimination in its programs, activities, and conditions of admission or employment. Learn more about these efforts and policies by visiting midmich.edu/eeo, midmich.edu/titleix, midmich.edu/securityreport.