Student Interest Form

Applicant Name *

Referred by *

First

Last

Address *

Email *

First

Last

Phone *

Current Status *

Employed
UnEmployed
Dislocated Worker
Under-employed

Employer Name, City, State: *

US Citizen *

Yes
No

Race

Gender

Age

Military Veteran *

Yes
No

Branch *

Discharge year & type *

Course Preferred *

2nd Course Preferred

Classes Times *

Days
Evenings
Either

Describe any IT Computer related trainingor employment you have ever had

Name of High School and Year completed *

Name of Colleges or Trade Schools attended. Years completed.List any degrees/certifications obtained *

Provide a brief statement about why you are interested in IT/Computer Training *

Indicate expected funding source(s) for tuition payments *

VA Benefits
WIOA/DOES
Non-Profit Organization
Special Program
Out-of-Pocket
Other

Comment or Message

GI Bill® is a registered trademark of the U.S. Department of Veterans Affairs (VA). For more info about VA education benefits go to: https://www.benefits.va.gov/gibill. Also see Enrollment Policy in current School Catalog for VAVR & E and GI-Bill individuals

The VETS Group is committed to offering programs that will lead to employment in high demand occupations in the IT industry and small business ownership.

Contact Information

1200 18th St. NW, Suite LL-100 Washington, DC 20036
202-822-0011
info@vetsgroup.org

Office Location

Washington

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