Learning Management System (LMS) Registration Form

This survey will gather information that is sent to the MiTEC Student Services team to create a user account for you in the Learning Managment System (LMS). This could take 24/48 hours. Please watch for an email with login information from BCAEO-MiTEC@Michigan.gov. 

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* 1. First & Last Name

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* 2. Email Address (This must be unique in the system)

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* 3. Mailing Address

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* 4. Cell Phone Number (This will be used for class reminders)

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* 5. Please enter BPI number (if applicable)

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* 6. What is your Weatherization hire date?

Date

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* 7. Are you employed by a Community Action Agency (CAA) or contractor to provide weatherization services? (If you are not affiliated with a CAA, you will be charged for training per DOE guidelines)

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* 8. Information of Employer/Manager (Enter your own name if self-employed)

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* 9. Select all agencies you/your company is affiliated with?

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* 10. What is your title or JTA in Weatherization.

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* 11. If you are a Contractor, what type are you? (Choose All That Apply)

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* 12. Enter all certifications you currently hold

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* 13. Emergency Contact

Demographic Data Collection

In order to promote diversity and equity in the Weatherization Assistance Program (WAP) workforce and measure the impact of Justice40 initiatives, we are seeking to collect demographic data of the WAP workforce for the following positions: Retrofit Installer Technician (RIT), Crew Leader (CL), Energy Auditor (EA), and Quality Control Inspector (QCI). 

Your responses to this form are voluntary and confidential. This includes making sure that any possible resulting publications, presentations, or requests for future funding do not make you identifiable in association with individual statements unless you request otherwise. Only the research team will have access to any feedback you provide. In any publications, presentations, or requests for future funding, we will report findings in aggregate, meaning we will not report individual data and/or results. Your identity will be carefully disguised in any subsequent use. We will keep the data indefinitely unless you contact one of the research partners or ask that your data be deleted. At a minimum, PI will maintain all records and data relating to this evaluation for at least six years after the completion of the project. By submitting this form, you are agreeing to the above privacy policy.  

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* 14. How many years have you worked in weatherization?

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* 15. Who is your employer?

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* 16. What is your age?

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* 17. What is your gender?

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* 18. What race or ethnicity best describes you? Select all that apply.

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* 19. What is your primary language?

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* 20. What is your veteran status?

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* 21. What is the highest level of education you have received?

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* 22. What is your primary job role?

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* 23. Which venue best describes the type of training you will be registering for?

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* 24. Which topic area best describes the type of training you have already received?

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* 25. Is your position covered by a collective bargaining agreement?

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* 26. Which of the following populations of interest does your company serve? Select all that apply.

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* 27. What is the 9-digit zip code of your residence? If unknown, please click the following link to locate your 9-digit zip code: https://tools.usps.com/zip-code-lookup.htm?byaddress

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