Information Session Registration

Please Select a Wednesday For Your 1-Hour Information Session Attendance Date (required)
---September 20, 2017September 27, 2017October 4, 2017October 11, 2017October 18, 2017October 25, 2017November 1, 2017November 8, 2017November 15, 2017November 22, 2017November 29, 2017

Anticipated Program Start Date (required)
---November 20, 2017February 5, 2018April 23, 2018Other (specify below in comments box)

First Name (required)

Last Name (required)

Phone (required)

Email (required)

Program Interest
---Construction GED Training ProgramHealthcare GED Training ProgramPre-Apprentice ConstructionConcrete Form CarpenterElectricianHeavy Equipment Operator (HEO)Residential CarpentryCommunity Health Worker (CHW)Community Health Worker with Certified Nursing Assistant (CNA) OptionMedical Administrative AssistantSenior Care CNA/CHW

Barriers (Please select any that apply)

No Barriers

Abuse

Child Care

Clothing

Drug/Substance Abuse

Financial Instability

Health Issues

Housing

Court Appearances

Relationship Issues

Transportation

How did you hear about us? (Please select any that apply)

KSTC (Channels 12/45)

WFTC (Channels 10/29)

CW (Channels 8/23)

KMSP

Pandora

KMOJ

Outdoor Billboard

Banner

Newspaper Article

Newspaper Ad

Event/Celebration

Flyer/Brochure

Facebook

Twitter

YouTube

LinkedIn

Internet Search

Mobile App Ad

Desktop Ad

Referred By (Please select any that apply)

Family/Friend

Summit Student/Alumni

Religious Institution

Organization

Workforce Center

STS/Corrections

Hennepin County

Ramsey County

Parole Officer

Comments:

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