Grant Assessment Submission Form - KW7879

The PC Professor campus you would like to attend: *

Which of the following best describes your scenario?

I have little or no computer experience.
I have experience in the computer industry but have no computer certifications.
I already have at least one certification and seek more.
None of the above.

Are you presently unemployed; or, have you been notified of a pending layoff within 180 days?

Yes
No

Are you receiving, or, have you exhausted, Unemployment Compensation benefits?

Yes
No

Are you actively seeking employment at this time?

Yes
No

Have you served in the US military with a minimum of 90 days of active duty service?

Yes
No

Do you currently receive either SSI (Social Security Income) or SSDI (Social Security Disability Income)?

Yes
No

Are you presently responsible for a child (or children) under the age of 13?

Yes
No

Family of 1 = $28,026; Family of 2 = $45,920; Family of 3 = $47,272; Family of 4 = $58,359; Family of 5 = $68,877; Family of 6 =$80,556; Family of 7 = $92,235; Family of 8 =$103,914. *

My household earning is currently LESS THAN the amount listed for my family size.
My household earning currently EXCEEDS the amount listed for my family size.

Family size includes those related by blood, marriage or court decree who live in a single residence.

Are you presently enrolled in Section 8 Housing, SNAP (Supplemental Nutrition Assistance Program) and/or TANF (Temporary Assistance For Needy Families)?

Yes
No

Were you previously self-employed and now unemployed due to economic conditions in the community?

Yes
No

Have you depended on the income of another family member, but are no longer supported by that income and experiencing difficulty in obtaining employment?

Yes
No

Are you under-employed (ie, not working to your full potential)?

Yes
No

Have you ever been diagnosed with Tourette Syndrome?

Yes
No
Prefer Not To Say

Have you been convicted of a felony?

Yes
No

If you were to receive a job offer upon completion of your training program, can you foresee any problems or adverse circumstances that might prevent you from accepting the employment? If so, please elaborate.

Please specify in what way you anticipate that the career training at PC Professor will assist you in achieving your career goals and/or assist you in advancing in your current position:

Your City Of Residence *

How did you hear of this funding opportunity? (Thanks for being as specific as possible!)

Name *

First

Last

Your Email *

Your Phone

I would like to be considered for any academic grants, scholarships and/or financing opportunities at PC Professor for which I may be qualified. I affirm that all information I provided is true and give the School permission to share my information with Federal, State, County, Municipal, private and/or non-profit agencies. My authorizing signature follows (use mouse, touchpad or touchscreen): *

Clear Signature

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