Keystone Technical Institute

Keystone Technical Institute Application For Admission

We are pleased that you are completing an application for admissions to Keystone Technical Institute. We ask that you complete this application thoroughly and carefully, remembering this is an important way for you to share information about yourself. We will review your application carefully and work closely with you as we make admission decisions. The mission of Keystone Technical Institute is to provide useful education; one that matches the career goals of the student with the needs of the employers in the student's chosen field.

*Indicates a required field

Personal Information:

* First Name:

* Middle Initial:

* Last Name:

* Todays Date:

* Address:

* Address2:

* City:

* State:

* Zipcode:

* Home Phone:

Cell Phone:

Birthdate:

Email Address:

Family Status:

Marital Status:

Do you have children?

Ages:

Need child care?

With whom do you live?

Employment Information:

Are you currently employed?

What type of work do you do?

What hours?

Where do you work?

Do you have a reliable means of transportation to get to and from school?

Are you interested in car pooling?

High School Information:

Name of high school:

City where high school is located:

State where high school is located:

Zipcode of high school:

Did you graduate from high school?

In what year did you graduate high school?

Do you have a GED?

Post Secondary School Information:

Have you attended any other post secondary schools?

Year(s) attended:

School's name:

Did you complete the program?

If not, please explain:

Year(s) attended:

School's name:

Did you complete the program?

If not, please explain:

Year(s) attended:

School's name:

Other Information:

Would you desire or require financial assistance?

At this point in your life, why do you want to better yourself?

I am interested in (what career):

What interests you about this field the most?

Time I would like to attend classes (may select both):

Day Classes Evening Classes

How long have you been considering furthering your education?

Less than 3 months
3-6 months
7-9 months
10-12 months
13-15 months
15 or more months

How soon do you want to start your training?

Once accepted, would you want placement assistance upon graduation?

*Indicates a required field

Personal Information:
* First Name:
* Middle Initial:
* Last Name:
* Todays Date:
* Address:
* Address2:
* City:
* State:
* Zipcode:
* Home Phone:
Cell Phone:
Birthdate:
Email Address:

Family Status:
Marital Status:
Do you have children?
Ages:
Need child care?
With whom do you live?

Employment Information:
Are you currently employed?
What type of work do you do?
What hours?
Where do you work?
Do you have a reliable means of transportation to get to and from school?
Are you interested in car pooling?

High School Information:
Name of high school:
City where high school is located:
State where high school is located:
Zipcode of high school:
Did you graduate from high school?
In what year did you graduate high school?
Do you have a GED?

Post Secondary School Information:
Have you attended any other post secondary schools?
Year(s) attended:
School's name:
Did you complete the program?
If not, please explain:
Year(s) attended:
School's name:
Did you complete the program?
If not, please explain:
Year(s) attended:
School's name:

Other Information:
Would you desire or require financial assistance?
At this point in your life, why do you want to better yourself?


I am interested in (what career):
What interests you about this field the most?


Time I would like to attend classes (may select both):
	Day Classes Evening Classes

How long have you been considering furthering your education?
	Less than 3 months 3-6 months 7-9 months 10-12 months 13-15 months 15 or more months
How soon do you want to start your training?
Once accepted, would you want placement assistance upon graduation?