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ESU Career Institute Application
Please complete the following information to a to apply to enroll.
All applicants must attend a o
ne on one consultation and an orientation.
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Last Name
*
Your answer
First Name
*
Your answer
Are you a SNAP recipient?
*
Yes
No
Cell Phone
*
Your answer
Home Phone
Your answer
Age
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
What is your current job?
Your answer
What is your career goal?
Your answer
Current Employer Name
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
What Certificaton course would you like to enroll?
Check all that apply.
*
Clerical Skills: Typing
Clerical Skills: Microsoft Word
Clerical Skills: Microsoft Excel Basics
Clerical Skills: 10 Key Punch
Clerical Skills: Office Etiquette
Customer Service Certification
Career Readiness Prep
Required
Thank you for applying for enrollment to the ESU Career Institute Certification program. You will recieve a call or email from esuscholars@gmail.com to setup your appointment for your one on one consultation and/or orientation within 48 hours.
Your answer
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