AT CERT App 2017: VA affiliates
Thank you for your interest in the AT CERT course. Below is the application for the 2017-2018 course. Applications will be accepted in June and July for 2017.

This application is specific to employees of the VA. If you are interested in applying but are not a VA employee, please use this application instead: https://goo.gl/forms/OkFxDFFd2n75FcXf1

The deadline for applying is Monday, July 24th at 11:59pm ET.

Email address
Alternate Email Address (optional)
If you have an alternate email (e.g. a personal email in addition to your professional email used above), you may enter it here. Some participants have requested we use the alternate email since they have limited access to their professional email.
Your answer
First Name
Your answer
Last Name
Your answer
Phone Number
Phone number will be used if email contact is unsuccessful or if your email changes.
Your answer
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