Enrollment Agreement

Industrial Training Academy

"Training that gets you working."

Welcome

Thank you for your interest in the Industrial Training Academy. To facilitate your enrollment, please complete the enrollment form. Once submitted, a representative will contact you to review and verify the accuracy of the information before proceeding. We appreciate your consideration of our school.

Full Name *

Email *

Phone Number *

Birth Date *

Social Security Number *

Emergency Contact Name *

Emergency Contact Number *

Emergency Contact Relationship *

Emergency Contact Address *

Are you a U.S. Citizen? *

Yes No

Course Information

Please select the option that best fits your desire.

Any uncertainties will be clarified during the interview.

Do you have a high school diploma? *

Yes No

What course are you interested in? *

HVAC Electrician Carpentry Other

Desired Projected Start Date: *

One Week Two Weeks Three Weeks One Month Not Sure

Course Format *

In-Person Hybrid (Online/In-Person)

Course Duration Interest *

Carpentry - 4 Weeks (Days) HVAC & Electrcian - 5 Weeks (Days) Saturday ONLY - 8 Weeks

Payment Method

We offer multiple payment methods for your convenience.

Select the options that best suit your needs.

Payment Methods *

Money Order Cashier's Check Cash Credit Card Payment Plan Financing

How did you hear about us? *

What is your primary language? *

Please upload your ID or Driver's License. *

Upload a file or drag and drop

50 MB limit per file

Enrollment Agreement *

I have filled out this form honestly and to the best of my abilities.