STEAP ENROLLMENT

Enrollment Application

SKILLED TRADE ENROLLMENT ASSISTANCE PROGRAM
Name

First NameLast Name
Email
example@example.com
DOB

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDATE OF BIRTH
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
SSN Last 4 Digits
last 4 only
Previous Felony?
If you answered YES, briefly explain. Please provide dates. (Additional assistance for felons who qualify)
explain
Do you have a social security card?
Do you have a valid Driver License?
Do you have an original Birth Certificate?
Do you have a GED or Diploma?
Please rate your math skills
*How Did You Find Out About STEAP?
What Skilled Trade Are You Interested In?
Every friday 6-9p

BMO SITE 4

6340 Stearns St, Detroit MI

If you have any questions please do not hesitate to contact the

STEAP Director Dino Vann

DVANN@STEAP.ORG

www.steap.org
Should be Empty:

Enrollment Application