Apply - Mobility Program Application

DiverseNote Mobility Program Application

Applications are being accepted.

Name *

First

Last

Address *

What city and state do you live in? *

Email *

Phone *

How did you hear about DiverseNote Mobility? *

What is your highest level of education? *

I have not graduated from high school
High school diploma or GED
Associate's degree
Bachelor's degree
Master's Degree
Doctoral degree

What DiverseNote Mobility program are you interested in? *

Intro to Cybersecurity
Intro to Programmng
Intro to Data Analytics
Intermediate Programming
Intermediate Cybersecurity
Electric Vehicle Systems
A program that is not listed here

Visit https://diversenote.mobi/programs to learn more about program options.

Why do you want to take a DiverseNote Mobility program? *

How would you like to attend classes? (Choose one option) *

Online Days Monday and Wednesday 9 AM - 11AM
Online Evenings Monday and Wednesday 6 PM - 8 PM
Online Days Tuesday and Thursday 9 AM - 11 AM
Online Evenings Tuesday and Thursday 6 PM - 8 PM

Our next programs take place in November and December. When do you prefer to start? *

November 2024
December 2024
A different date

If you would like a different start date, enter the date below.

How would you like to pay the tuition for your program? (Choose at least one) *

Michigan Works Tuition Assistance or other American Job Center office
Credentialing Assistance (Military only)
MRS
Tuition Payment Plan (Tuition payment plans start at $250 per month with a down payment requirement. Apply for Payment Plan
Pay full tuition

If you selected Michigan Works or American Job Center, and you are working with a career coach, what location are you working with and what is the name, phone number, and email address of your career coach or counselor there? If you are not currently working with a Michigan Works or American Job Center office, type N/A. *

Are you currently employed? *

Do you make under $45,000 a year? *

Do you have a valid state ID or driver's license? *

Would you Like to refer a friend to DiverseNote Mobility? Enter their first and last name and email address below.

Referral 1: Enter first name, last name, and email address.

Referral 2: Enter first name, last name, and email address.

Referral 3: Enter first name, last name, and email address.

Is there anything else you'd like us to know at this time?

Name

Contact

Email: start@diversenote.mobi

Location

440 Burroughs St.

Detroit, MI 48202

Monday – Thursday

9am – 6pm