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 100% of survey complete.
Section 1: Applicant Contact Information

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* 1. First & Last Name:

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* 2. Position/Role:

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* 3. Email Address:

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* 4. Contact Phone Number:

Section 2: About Your School or Institution

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* 5. Name of School, Training Center, or Institution:

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* 6. School Address:

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* 7. School Phone Number:

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* 8. School Board (if applicable)

Section 3: Faculty Signing Authority
*Please note that they will be contacted upon your application’s review to confirm awareness of and verify endorsement of your application*

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* 9. Name of Faculty Supervisor with Signing Authority

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* 10. Job Title of Faculty Supervisor with Signing Authority

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* 11. Signing Authority Telephone Number

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* 12. Signing Authority Email Address

Section 4: Existing Welding Facilities

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* 13. Do you currently have a welding and/or materials joining program?
(Select all that apply)

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* 14. Do you have a dedicated welding lab/workshop?

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* 15. What is the approximate age of your welding lab/workshop?

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* 16. What is the approximate current size of your welding lab/workshop? (in sq feet)

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* 17. How many welding booths does your welding lab/workshop have?

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* 18. What types of welding machines do you currently have?
(Select all that apply)

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* 19. What other metalworking or manufacturing equipment do you have in your welding lab/workshop?
(Select all that apply)

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* 20. What major limitations does your workshop currently face?
(Select all that apply)

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* 21. Does your workshop/facility have access to the following?
(Select all that apply)

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* 22. Please submit 1 of 2 photos of your welding workshop:

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* 23. Please submit 2 of 2 photos of your welding workshop:

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* 24. Please submit 1 of 2 photos of the area best suited for the Siegmund Workbench in your workshop.
Overall tabletop size - 1500x1000mm (59.06" x 39.37")

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* 25. Please submit 2 of 2 photos of the area best suited for the Siegmund Workbench in your workshop.
Overall tabletop size - 1500x1000mm (59.06" x 39.37")

Section 5: Existing Programs

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* 26. Please list the welding and related courses that you currently run that would benefit from using a Siegmund Workbench.

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* 27. Does your school participate in industry partnerships, mentorships, or career fairs related to welding?

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* 28. Has your school previously received funding from the CWB Association and/or CWB Foundation?
(select all that apply)

Section 6: Value and Vision

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* 29. Why would you feel your school is the best candidate to win one of the Siegmund Workbenches for your programs? How will this impact your programs?

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* 30. What would be a project that your welding and joining classes would like to build on the Siegmund Workbench?

Section 7: Final Thoughts

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* 31. Have you contacted your school or organization’s administration to ensure you will have administrative support for paperwork and reporting requirements?

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* 32. Do you have any additional questions or concerns about the program?

Section 8: Sign Off

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* 33. By checking this box, you agree that all answers in this survey are accurate to the best of your knowledge.

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* 34. This application is electronically signed by:
(insert your first and last name)

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