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* 1. Name (first, middle, last)

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* 2. Contact phone numbers (home and cell)

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* 3. Mailing address (street, city, state, zip)

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* 4. Education level 

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* 5. Work experiences

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* 6. Career goals

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* 7. I verify that I have no arrest record and can pass a drug screen (urine test). Check all that apply.

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* 8. I understand that registration on Thursday, March 8, 2018 is first come first served and that the $650.00 tuition and fees are due in full at the time and are non-refundable. 

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