Apply For Admission -

Personal Information

First Name:*

Middle Name:

Last Name:*

Email*

Phone*

Are you a veteran?*

Yes

Do you have benefits?

VA Post 911

GI Bill

VA Voc (Ch31)

Other

Are you Eligible for VA Benefits?

Yes

Are you applying through a government agency?*

Yes

Agency Name

Contact Name

Contact #

Criminal Record:*

Yes

If yes, describe:

Known Medical Condition:*

Yes

If yes, describe:

Disabilities:*

Yes

Some disabilities may prevent you from working in your chosen field

If yes, describe:

U.S. Department of Education Information

The following information is collected to compile reports required by the Department of Education and will not be used to determine enrollment.

Age:*

Gender:

Male

Female

Not Specified

Race/Ethnicity:

American Indian

Asian

Black/African American

Hispanic

White/Caucasian

2 or More Races

Unknown/Unspecified

Citizenship:

US Citizen

Non-Citizen

Eligible Non-Citizen

Unknown

In Case of Emergency

1st Contact Name:*

Cell Phone:*

Relationship*

2nd Contact Name:

Cell Phone:

Relationship

Current Living Situation

Living with parents

Living off campus (not with parents)

Educational Experience

Have you attended another college?

Yes

Are you interested in receiving transfer credits(s)?

Yes

Do you have any loans in default?

Yes

Institution Name:

State:

Year:

Received Financial Aid?

Yes

Received Degree? Type of Degree?

Yes

Institution Name:

State:

Year:

Received Financial Aid?

Yes

Received Degree? Type of Degree?

Yes

How Did You First Hear About Us?*

Attestation

Everything I have stated in this application is correct to the best of my knowledge. I understand that you will retain this application whether or not it is approved. You are authorized to check my employment history and to answer questions about any future credit experience with ITI Technical College.

Applicant’s Signature*

Date

Admission’s Advisor Signature

Date of interview

^* Required
We Value Your Privacy.
We know you are anxious to get started on your new career. By pressing the button in the form on this page, I understand that ITI Technical College may call and/or text me about educational services at the phone number provided, including a wireless number, using automated technology. Your information will only be used by ITI Technical College. We do not and will not sell your information to any other party. Please note, that you are not required to provide this consent to attend our institutions.
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Apply For Admission

Apply For Admission

Personal Information

U.S. Department of Education Information

In Case of Emergency

Educational Experience

Attestation

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