New (Current) Admissions Application

(Current) Admissions Application

Program

Course Name & Dates

Age

Birth Date

Social Security Number

First Name

Middle Name

Last Name

Mailing Address

City

State/Province

Zip/Postcode

Cell Phone

Home Phone

Citizenship

Are you or have you been a member of the U.S. Military

Yes No Not Selected

How did you hear about the Industrial Arts Institute?

Disability or Learning Difficulties

Disability

Yes No

Disability Description

Learning Difficulties

Yes No

Learning Difficulties Description

Are there any special accommodations/circumstances you would like us to be aware of?

Emergency Contact Information

Contact Name

Relationship

Cell Phone

Work Phone

Privacy and Communication Permissions Policy

https://iaiworks.com/privacy-policy/

Signature Date

Privacy & Commnication Permissions Policy

The information in this application is accurate. I understand that providing false information may lead to disciplinary action, including dismissal. By submitting this application, I grant permission for IAI to communicate with me via phone, USPS mail, email, and text (SMS)messaging. By opting into SMS from this online application, you agree to receive SMS messages from Industrial Arts Institute, Inc. This includes SMS messages for appointment scheduling, appointment and other training-related reminders, post-visit instructions, billing notifications, and employment opportunities. Message frequency varies. Message and data rates may apply. See privacy policy at https://iaiworks.com/privacy-policy/

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Industrial Arts Institute does not and shall not discriminate based on race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities, operations, or the administration of educational policies, admissions policies, scholarship and loan programs, or other school-administered programs.