Apply-CA - Mobility Credentialing - DiverseNote Mobility

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Phone *

Race / Origin *

Gender *

Date of Birth *

Highest level of education. *

Applicants are requested to answer the next two questions voluntarily.

Are you a U.S. Military service member, veteran, or dependent?

Do you have a disability?

What credential only program are you applying for? (View academic program information at https://diversenote.mobi/credential) *

Are you interested in Dual Enrollment?

Learn more about dual enrollment at https://diversenote.mobi/dual-enrollment

Online or In-person training? *

In-person training is only available on our Detroit based campus. Welding, Auto Technician, Electrical Technician, and Electric Vehicle Systems can only be done in-person.

What schedule are you interested in? *

Weekday Morning (9AM-12PM)
Weekday Afternoon (1PM-4PM)
Weekday Evening (6PM-9PM)
Weekend Morning (Saturday and Sunday 9AM-12PM)

When would you like to start? *

Spring - between April and May
Summer - between June and August
Fall - between September and November
Winter - between December and March

Why would you like to enroll in a DiverseNote Mobility Program? *

What tuition payment option do you qualify for? *

Are you currently or have you ever been charged with or subject to disciplinary action for scholastic or any other type of misconduct at any educational institution? *

Yes
No

For Non-U.S. Citizens Only

City and Country of Birth

Agreement

I understand that this application is for admission only for the term indicated. I agree that I am bound by the Academy's regulations concerning application deadlines and admission requirements. I agree to the release of any transcripts and test scores to this institution, including high school and/or college GPA, reading and math level, any SAT, and/or ACT score reports. I certify that this information is complete and accurate. I understand that making false or fraudulent statements within this application or residency statement may result in disciplinary action, denial of admission and invalidation of credit or degrees earned. If admitted, I agree to abide by the policies of the Board of Regents and the rules and regulations of the Academy. Should any information change prior to my entry into the Academy, I will notify the Office of Admissions.

Do you understand and agree to the terms listed above? *

Yes, I understand and agree to the terms listed above.

Events, activities, programs and facilities of the Academy are available to all without regard to race, color, marital status, gender, religion, national origin, disability, age, nor veteran status as provided by law and in accordance with the Academy's mission of all-inclusive diversity.

DiverseNote Mobility Credential Only Application

For Non-U.S. Citizens Only

Agreement