First Name Middle Name Last Name

Mailing Address

house number, Apt# & street City State Zip
Home Phone Number Alternate Contact no.
Email Address
Country of birth Country of citizenship*

*If you are not a US citizen, state your immigration status: VISA Permanent Alien A#

Gender Select Male Female Marital status: Select Married Single

EDUCATION

List all High Schools attended	Location (City,State,Zip)	Dates of Attended From - To

Did you graduate high school Select Yes No
Do you have a GED Select Yes No State of issue

Did you leave the last school you attended in good standing? Select Yes No

Have you ever been suspended or expelled from any school, college or university? Select Yes No

How did you learn about the School?

WORK EXPERIENCE

Employer	Position	Dates of Employment From	To

Placement Waiver:

I DO wish to receive job placement assistance after graduation from course Select Yes No

Please note that SEE cannot and does not guarantee a job to any graduate.

$50 Application Fee must accompany application