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Class A Barber Questionnaire
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* Indicates required question
Are you interested in Tuition Assistance? (Funding is through Texas State organizations)
*
Yes
No
Full Name
*
Your answer
Current Home Address
Your answer
Phone Number
*
Your answer
Preferred way to contact you
*
Phone Call
Email
Text Message
Required
Email Address
*
Your answer
Age
Your answer
Sex
Female
Male
Prefer not to say
Other:
Clear selection
Please select all ethnic backgrounds that apply to you
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian and Other Pacific Islander
Hispanic or Latino
Are you a Veteran?
Yes
No
Clear selection
What is your primary language?
*
English
Spanish
Other:
Employment Status
*
Employed
Self-Employed
Unemployed
If Employed, where do you work?
Your answer
Have you ever been convicted of, pleaded guilty to, incarcerated or been placed on probation for any crime? (misdemeanor, controlled substance, robbery, assault, etc.)
*
Yes
No
If you answered yes, please explain.
Your answer
Do you own or have access to reliable transportation?
*
Yes
No
If you answered no, please explain how you would plan to get to and from school.
Your answer
What school location are you interested in attending?
*
League City
Texas City
Required
How many hours can you attend a week? Check all that apply.
20 hours
30 hours
40 hours
Select what class times you would interested in. Select all that apply.
*
7am-11am
11:30am-3:30pm
9am-1pm
1:30pm-5:30pm
6pm-10pm
Required
Do you have a high school diploma or a GED?
Yes
No
Clear selection
Are you in need of accommodations (physical, learning, etc.) to ensure your success while at school?
*
Yes
No
If so, please explain
Your answer
What are some obstacles that you have overcome?
Your answer
What are some obstacles that you still have left to overcome?
Your answer
What are 3 personal or professional goals that you have?
Your answer
How can barbering help you reach your goals?
*
Your answer
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