PINACLES Admission Application
Admission Application for the PINACLES program. 
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Introduction
Complete the application for admission to the PINACLES program at Kelm Academy funded by the Department of Social Services.  The Registrar's Office will notify you of your application process within two weeks.  Upon acceptance to the program, you will be required to complete the registration process and attend an Orientation session.  ALL INFORMATION WILL REMAIN PRIVATE AND CONFIDENTIAL.
Full Name *
Email Verification
A valid email is required to send confirmation of your admission application.
Email *
Phone Number *
Address *
Resident County *
Age Group *
Date of Birth *
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Last 4 social *
SNAP recipient *
Enter Case # *
Would you need childcare services? *
Would you need travel fare assistance? *
PINACLES Term *
Training Format Preference *
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