Technical Apprentice Application

Street Address

City

County of Residence

State

Zip code

Phone number

Email address

Date of birth?

What is your citizenship?

US CitizenOther

Are you currently employed?

YesNo

If yes, what is your company name?

In what city are they located?

How long have you worked for this company?

What is your position?

If currently unemployed, are you receiving unemployment benefits?

YesNo

Are you currently furloughed from your previous employer?

YesNo

If yes, what is the name of your previous employer?

In what city are they located?

What is your educational history?

Have you ever attended a collision class or workshop?

YesNo

Have you ever taken any ICAR classes?

YesNo

If so, what classes and where?

Do you have access to an internet-connected device for at least one hour a day for two weeks? Check any/all that apply

Are you sheltering in place?

YesNo

County of Residence

Contact type