Student Application: The Grooming Project
You will need at least a half an hour to complete this application. Please review it first and gather the information needed to complete it.
Email address *
Name (first and last) *
Your answer
Number of children currently living with you under the age of 18: *
Full Address including City, State, Zip: *
Your answer
Phone Number(s): *
Your answer
Email Address: *
Your answer
Emergency Contact Name: *
Your answer
Emergency Contact Relationship: *
Your answer
Emergency Contact Phone Number: *
Your answer
Current Employer (or indicate if unemployed) *
Your answer
Number of Hours Worked (Employed?) Last Month: *
Are You Left or Right Handed? *
Please indicate how far you’ve gone in school. *
What is your best estimate of your average household monthly income last year? *
Please indicate your current housing status: *
What is your primary means of transportation? *
What type of child care are you currently using for your child /children under 5 years old? *
What childcare do you use for your school age child/ children before and after school? (Please specify) *
Your answer
What agencies do you use for housing if any? (Please specify.) *
Your answer
Do you have any medical condition that could limit your learning or affect your ability to complete the program? If no, please indicate NO, If YES, please specify. *
Your answer
DIRECTION FOR THE NEXT SECTION:
Complete the next questions using the rating scale below. Put a checkmark in the box that best describes you. There are no correct answers, so please honestly assess yourself.
Check only one box for each question.
I accept responsibility for my behavior *
Almost Never
Always
Friends describe me as doing what is right because it’s the right thing to do. *
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose one
I meet or exceed what is expected of me. *
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose one
I am afraid of dogs.
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose one
I volunteer to help others whenever possible. *
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose One
I encourage others to provide constructive feedback on how I can improve my performance. *
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose One
I use constructive feedback offered by others to improve my performance.
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose One
I willingly admit limitations to my knowledge. *
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose One
I exhibit personal accountability in how I live my life. *
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose One
I have patience even when things are difficult.
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose One
I understand the importance of confidentiality. *
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose One
I am a punctual person. *
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose One
I require continuous one-on-one instruction when I’m learning something new. *
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose One
Friends and family consider me a leader. *
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose One
I am able to work on my own once I have been instructed. *
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose One
I work well with other learners. *
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose One
I stay calm when I find myself in a difficult position. *
Almost Never
Sometimes
Frequently
Almost Always
Always
Choose One
BRIEFLY ANSWER THE FOLLOWING QUESTIONS IN YOUR OWN WORDS
Describe why you would like to be a qualified dog groomer. *
Your answer
Identify what you consider your best qualities to be. (Please list) *
Your answer
What is/are your greatest obstacle(s) right now? *
Your answer
Do you have any skills that might be related to dog grooming or dealing with the public? (e.g., previous jobs, training, personal interests, school activities etc.) *
Your answer
Writing your name below is your signature *
Your answer
Three references are required. Please list names and contact information below. *
Your answer
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