STEAP ENROLLMENT

Enrollment Application

SKILLED TRADE ENROLLMENT ASSISTANCE PROGRAM
Name*

First NameLast Name
Email
example@example.com
DOB*

MonthDayYear
DATE 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?*

YESNO
If you answered YES, briefly explain. Please provide dates. (Additional assistance for felons who qualify)
explain
Do you have a social security card?*

YESNO
Do you have a valid Driver License?*

YESNO
Do you have an original Birth Certificate?*

YESNO
Do you have a GED or Diploma?*

YESNO
Please rate your math skills*

TerribleUnsureit's been a long timeCollege Level
*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
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Enrollment Application