Manufacturing Associate Certification Program (ELL Support Available)

Application Form

Question Title

* 1. Applicant Information

Full Name

Mailing Address

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 2. Date of Birth

Question Title

* 3. Gender

Male

Female

Other (please specify)

Question Title

* 4. Military Status

None

Veteran

Service Disabled Veteran

On Active Duty

Member of National Guard

Member of Reserve

Question Title

* 5. Select the highest level of schooling you have completed. A high school diploma/GED/high school equivalency is required to participate in this program.

High school diploma/GED/high school equivalency (required for this program)

Some college, no degree

Associate's Degree

Bachelor's Degree

Master's Degree

Question Title

* 6. Do you receive Supplemental Nutrition Assistance Program (SNAP) benefits and/or TANF/TAFDC?

SNAP Benefits

TANF/TAFDC

N/A (not applicable)

Question Title

* 7. Current Employment Status

Full-time (35+ hours per week)

Part-time (less than 35 hours per week)

Unemployed

Question Title

* 8. If you are currently employed, where do you work?

Question Title

* 9. If you are currently employed, what is your job title?

Question Title

* 10. Do you have any experience in the manufacturing industry?

Yes

Question Title

* 11. If you do have experience in manufacturing, briefly describe your manufacturing work experience.

Question Title

* 12. If you do not have direct experience in manufacturing, do you have experience in any of the phases of fabrication outside of the manufacturing industry? (Reading and/or preparing blueprints, purchasing and assembling materials, hands-on crafting, engineering or robotics, etc. )

Question Title

* 13. If you do not have experience in manufacturing, do you have experience in a technical field such as automotive technology, electronics, carpentry, HVAC or another related field?

Manufacturing Associate Certification Program (ELL Support Available)

Application Form

Question Title

* 1. Applicant Information

Question Title

* 2. Date of Birth

Question Title

* 3. Gender

Question Title

* 4. Military Status

Question Title

* 5. Select the highest level of schooling you have completed. A high school diploma/GED/high school equivalency is required to participate in this program.

Question Title

* 6. Do you receive Supplemental Nutrition Assistance Program (SNAP) benefits and/or TANF/TAFDC?

Question Title

* 7. Current Employment Status

Question Title

* 8. If you are currently employed, where do you work?

Question Title

* 9. If you are currently employed, what is your job title?

Question Title

* 10. Do you have any experience in the manufacturing industry?

Question Title

* 11. If you do have experience in manufacturing, briefly describe your manufacturing work experience.

Question Title

* 12. If you do not have direct experience in manufacturing, do you have experience in any of the phases of fabrication outside of the manufacturing industry? (Reading and/or preparing blueprints, purchasing and assembling materials, hands-on crafting, engineering or robotics, etc. )

Question Title

* 13. If you do not have experience in manufacturing, do you have experience in a technical field such as automotive technology, electronics, carpentry, HVAC or another related field?

Question Title

* 14. Specifically, what attracts you to pursuing credentials in the manufacturing field?

Question Title

* 15. What do you hope to gain from your participation in this program?

Question Title

* 16. How did you hear about this opportunity?