VTI Sponsored Participant Intake Form

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For students interested in getting sponsorship at Ventura Training Institute, please fill this form out. Once completed, this will give us an idea of where we can refer you to get the sponsorship in our program. All information provided will be kept confidential and only shared on a need-to-know basis. If you have any further questions, please call us at (805) 385-5485

Email *

First and Last Name *

Phone number *

Address, City, State and Zip Code *

Date of Birth *

YYYY

Age *

I identify my gender as _________ *

Female

Male

Prefer not to say

Other:

What is your ethnicity(ies)? Please check all that apply

Asian or Pacific Islander

Black or African-American

Hispanic or Latino

Native American, Native Alaskan or Native Hawaiian

Two or more races

White

Other:

Required

What is your household income?
*

Less than $24,999

$25,000 to $49,999

$50,000 to $74,999

$75,000 to $99,999

$100,000 to $149,999

Over $150,000

What is the highest degree or level of school you have completed? (If you’re currently enrolled in school, please indicate the highest degree you have received.)
*

Less than a high school diploma

High school degree or equivalent (e.g. GED)

Some college, no degree

Associate degree (e.g. AA, AS)

Bachelor’s degree (e.g. BA, BS)

Master’s degree (e.g. MA, MS, MEd)

Professional degree (e.g. MD, DDS, DVM)

Doctorate (e.g. PhD, EdD)

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