Information Session Registration

Please Select a Wednesday For Your 1-Hour Information Session Attendance Date (required)
---July 19, 2017July 26, 2017August 2, 2017August 9, 2017August 16, 2017August 23, 2017August 30, 2017September 6, 2017September 13, 2017September 20, 2017September 27, 2017October 4, 2017October 11, 2017October 18, 2017October 25, 2017

Anticipated Program Start Date (required)
---September 11, 2017November 20, 2017Other (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 Stability

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

BMA-TV

BlackMusicAmerica.com

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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