Program Application for Customer Service Institute or Business Office Administration Training (BOAT)

Personal Information
    Application Date:                                                      * Required Fields
  1.  Last Name:                     *   First Name:   *   MI:   * If no middle initial, please Enter #.
  2.  Address:                          *     Apartment/Unit#:  
     City/State/Zip:                   *
 
  3.  Primary Phone:                   *                                          Alt Phone:  
  4.  Email Address:                *                 
  5.  Birth Date:                        Month:   * Day:  * Year:  * 6.  Age:  
  7.  U.S. Citizen?:                   * Visa type: 
  8.  Gender:                            *
  9.  Ethnicity:                          *
10.  Race:                                *
11.  Selective Service Status:   *       Selective Service Number:  
12.  Veteran Status:              *   If yes, Date(s) of Service:  
13.  Spouse of Veteran:        *
14.  Branch of Military:       
Employment Status
15.  Currently Employed?:   * Underemployed: working part-time or working job not commensurate with skills and education.
16.  Monthly Income:           *
17.  Receiving Unemployment Insurance?: *
18. Laid Off?:                        *
        TANF?:                          *
        Food Stamps?:               *
19.  Highest Education Level:   High School Diploma or equivalent is required. *
20.  Education Goal:              *
21.  MET Program Interest:   *
22.  Please Share With Us How You Learned About the Program:                  Other Source:   *
       Comments:                     
The creation of this online program application was 100% funded by the MoSTEMWINs $19.7 million grant from the U.S. Department of Labor, Employment and Training Administration (TAACCCT).The product was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership.