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

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 Welding Other

Desired Projected Start Date:

One Week Two Weeks Three Weeks One Month Not Sure

Course Format

In-Person Hybrid (Online/In-Person)

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

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.