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ASPRA Tech Center Student Registration
Name
Primary Phone Number
Alternate Phone Number
Driver License Number
Social Security Number
Heard About Us
Are you a
Self Paid
Corporate Sponsered
Government Agencies Sponsered (OMJ, BVR, etc)
Are you a former student of Cleveland Industrial Training Center?
Yes
No
If yes, which program did you take?
CNC training
Swiss training
Email Address
Date of Birth
Present Address
City
State
Zip Code
How long have you lived at the present address?
Previous Address
How long have you lived at previous address?
Emergency Contact Name/Number
Relationship to the Emergency Contact
Are you a U.S. Citizen
YES
NO
If NO, please upload your Passport & Visa pictures
Are you legally eligible for employment in the U.S.A?
YES
NO
EMPLOYMENT HISTORY
How did you hear about ASPRA Tech Center?
Last level of education completed?
GED
HIGH SCHOOL
ASSOCIATES
BACHELORS
MASTERS
PhD
Year of completion?
GED obtained in which year? (If high schooling is done then you can skip)
GED obtained in which location? (If high schooling is done then you can skip)
Are you a veteran?
YES
NO
If yes, what Branch?
Have you been convicted of a felony in the last seven years?
YES
NO
If yes, give an overview of the felony including dates and outcome, etc:
Do you have any pending court cases?
YES
NO
If yes, please list details including dates
Please list names of other who may be interested in ASPRA Tech Center CNC program: Format: Name Number Relationship
Please tell us why you are interested in CNC machining?
In which class you are interested?
Day Classes (8 AM to 12 PM)
Afternoon Classes (1 PM to 5 PM)
Evening Classes (5 PM to 9 PM)
Please upload your Social Security Card ID front picture
Please upload your Social Security Card ID back picture
Please upload your Driving License front picture
Please upload your Driving License back picture
SELF DECLARATION: The fact set fourth in my application are true and complete. I understand that falsification of information will result in my dismissal from ASPRA Tech Center. By selecting "Yes" you are legally bound to your responses given above. By selecting "No" your application will be canceled
Yes
No
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