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BVEdHub Summer Course Application
This is an application. A seat in class is NOT guaranteed until your application is approved. If your application is approved, you will receive an email notifying you of your successful registration. Questions regarding participation should be addressed to Bob Evans evans.bob@bv-edhub.org
**PLEASE NOTE- THE OSHA COURSES HAVE BEEN CANCELLED AND THE WELDING COURSE IS FULL
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Email:
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Application Date
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Full Legal Name (please share if you have a preferred name):
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Please select which course you are interested in:
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CNC Machinist Apprentice
Online course (see course menu which is linked in the flier)
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If you selected online course, please specify which course below:
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Date of Birth
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Current address (MUST include- street address, city/town, zip code)
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Best phone number to be reached at:
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Your answer
Identified sex:
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Male
Female
Prefer not to say
Other:
Emergency Contact Information (Name, phone number, and relationship to you):
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Your answer
Education Status:
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Did not finish high school
HS Grad/GED
Some college course work
College degree
What is your highest grade of completion?
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Your answer
Are you a U.S. Citizen?
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Yes
No
Is English your primary language spoken? If no please indicate which language in the "other" space.
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Yes
No
Other:
Race/Ethnicity:
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White
Hispanic or Latino
Asian
Black or African American
American Indian or Alaskan Native
Hawaiian Native or Other Pacific Islander
Other:
Family Status- check all that apply:
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Single
Married
Parent
Other
If you are a parent, please indicate the number of dependents under age 18?
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Are you currently receiving unemployment benefits? If so, how many weeks out of the past 26 weeks have received unemployment benefits?
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Please check all that apply:
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Disabled
Offender/Police Record
Public Assistance (Housing, Food Stamps, TAFDC)
Veteran
Limited English Proficiency
Unemployed
Employed
Other:
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If you are currently working or have worked in the past 6 months, please list the jobs below (please include: Employer name, Address, Phone Number, Dates of Employment (to and from), job title and hourly wage:
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Any issues we need to be aware of (i.e. CORI, Transportation, Childcare, etc.)
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How did you hear about this training?
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Please tell us a why would you like to take this training course and your goals after the training:
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I certify that this information above is accurate and true to the best of my knowledge that there is no intent on my part to commit fraud. I understand that the above information will be used to determine applicant eligibility and is subject to verification. I further understand that completion of this application is no guarantee that I will be accepted into a program. Typing your name below is acknowledging this form's information and in place of your signature:
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