A title

Personal Information

Are you registered with selective services?
Are you authorized to work in the U.S.?
May we share information about your application/enrollment with the referral source you listed?
I have state issued I.D. and I am eligible to be present in a public school environment (EWCTC students only).

Employment History

Please list your last three employers. Start with your present or most recent employer.

Education / Military Experience

Please provide as much information as possible.

Did you graduate?
Did you graduate?
Did you graduate?

Demographics

Gender
Ethnicity – Please mark all that apply
Age
Please mark all that apply
Household Income
Are you currently employed?
Have you recently lost your job or experienced a reduction in wages?
Are you the head of your household?
If not, what gender is the head of your household
Are you the parent to one or more dependent children?
Are you a recipient of SNAP (Supplemental Nutrition Assistance Program)?
Were you on the BotsIQ team at your high school?

Questionnaire

Please write a few sentences for each question. One word answers will not be accepted.

Course Preference

Location First Choice Second Choice Days and Times
Day Programs
M2K – Pittsburgh (South Side)
305 East Carson Street
Pittsburgh, PA 15219
Monday – Friday, 9:00 am – 3:00 pm
Class duration: 4-6 months
Evening Programs
M2K – Pittsburgh (South Side)
305 East Carson Street
Pittsburgh, PA 15219
Monday & Wednesday, 4:00 pm – 10:00 pm
Class duration: Approximately 1 year
M2K – Latrobe
4904 Route 982
Latrobe, PA 15650
Monday – Friday 4:00 pm – 9:00 pm
Let us know which day(s) you are interested in.
Class duration depends on hours per week