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Skilled Trade Academy Application
OWL
2023-10-31T23:18:53-05:00
Skilled Trade Academy Application
Skilled Trade Academy Application
Skilled Trade Academy Application
Name
Name
First
First
Last
Last
Referral Source / How did you hear about us?
Date of Birth
Age
Male
Female
Address
Address
Address
Address
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
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New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
Phone
Preferred method of contact?
Phone
Text
Email
Mail
Emergency contact information:
Name
Name
First
First
Last
Last
Address
Address
Address
Address
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
Relationship
Phone
Email
Housing
Rent
Rent with Assistance
Own
Transitional
Living with Friend or Relative
Other
Other
In what other states nave vou lived
Race/Ethnic Heritage
AsIan
Black/African/African American
Hispanic or Latino Descent
Multi-Racial
Native American or Alaska Native
Pacific Islander or Hawaiian Native
White
Middle Eastern
Other
Other
Transportation
Do you have a Valid Driver's License
Yes
No
If no, please explain
What type(s) of transportation do you often use?
City Bus
Carpool
Personal Vehicle
Wheels
Other
Other
Education
What is the highest grade level you have completed?
Do you have a High School Diploma?
Yes
No
Year received
Name of High School
City, State
Do you have a GED?
Yes
No
Year received
Institution
Work Licenses/Certifications
Are you proficient in any additional languages?
Yes
No
If yes, please list
Military Service
Did you serve in the military
Yes
No
Branch
Rank
Duties Performed
Active Dates
Type of Discharge
Active in National Guard or Reserves?
Yes
No
Physical Skills/Abilities
Vision impairment?
Yes
No
If yes, is it corrected?
Yes
No
Hearing impairment?
Yes
No
If yes, is it corrected?
Yes
No
Physical/Vocational Limitations
Would you have trouble performing a job with repetitive activities/tasks?
Yes
No
If yes, please check applicable box(es)
Standing
Bending
Lifting
Sitting
Fine Motor Use of Hands
Walking
Stooping
Reaching
Climbing
Other
Other
Can you lift 50 pounds?
Yes
No
Environmental Restrictions
Would you have trouble performing a job in any of these conditions?
Yes
No
If yes, please check the appropriate boxes below.
Would you have trouble performing a job in any of these conditions?
Inside
Outside
Extreme Heat
Extreme Cold
Wet/Humid
Dusty/Dirty
Noise
Heights
Allergies
Other
Other
List any allergies
Employment Experience
Most recent Employer
City/State
Phone
Employment Start Date
Employment End Date
Job Duties
How many total years of employment have you had?
Do you have any construction trades experience?
Yes
No
If yes, how many years?
Legal History
*Skilled Trade Academy prohibits unlawful discrimination or harassment based on race, color, creed, national origin, sex, age, disability, marital status, sexual orientation, military status, prior record of arrest or conviction, citizenship status, current employment status, or caregiver status.
Do you consent to a criminal background check?
Yes
No
Do you have any pending charges?
Yes
No
(A conviction does not necessarily exclude applicant from acceptance into this program.)
In consideration for admittance to OWL Skilled Trade Academy, I authorize OWL Skilled Trade Academy or its representative to conduct a criminal record background check. My signature below constitutes my request to any Federal, State, or Local Law Enforcement Agency to release whatever information is requested by OWL Skilled Trade Academy or its representative.
Confirm
Name
Name
First
First
Last
Last
Social Security Number
Street Address
Street Address
Street Address
Street Address
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
I would like to receive emails from OWL and Skilled Trade Academy.
*
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