Palmer Pathways Interest Form

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* 1. Name

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* 2. Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

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* 3. Email

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* 4. Phone Number

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* 5. May we text you at this number?

Yes

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* 6. Date of Birth

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* 7. Are you between the ages of 18 and 26 years?

Yes

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* 8. What is your current educational status?

Currently in high school

High school graduate/GED

Currently enrolled in college

Did not attain high school diploma/GED

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* 9. Are you a Pierce County resident?

Yes

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* 10. Are you a person of color?

Yes

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* 11. What construction trade are you most interested in?

Brick Masons & Allied Trades

Roofers, Watersealers, & Allied Trades

Carpentry

Ironworkers

Laborers

Public Transportation Infrastructure

Sheet Metal

Pipefitting

Electrician

Painters & Allied Trades

Operating Engineers

Undecided

Other (please specify)

Palmer Pathways Interest Form

Question Title

* 1. Name

Question Title

* 2. Address

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* 3. Email

Question Title

* 4. Phone Number

Question Title

* 5. May we text you at this number?

Question Title

* 6. Date of Birth

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* 7. Are you between the ages of 18 and 26 years?

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* 8. What is your current educational status?

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* 9. Are you a Pierce County resident?

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* 10. Are you a person of color?

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* 11. What construction trade are you most interested in?

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* 12. How did you hear about this program?

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* 13. Name the person who referred you, if applicable.