Sbcg Training Application

Sensible Business Career and Training Institute 36660 Cherry Hill Westland, MI 48185 734.620.9461

An equal access, equal opportunity, affirmative action employer that is committed to a diverse workplace. Please print using ink, or type.

1. Social Security # _____________ — _________ — __________________ 2. Name _____________________________________________________________________Preferred Name _______________________________ Last First Middle

3. Home Address _________________________________________________________________________________________________________________________ Number & Street

_________________________________________________________________________________________________________________________ City State Zip County (if Michigan Resident)

4. Phone Number ______________________________________

5. Gender Male / Female

6. E-mail Address _________________________________________ 7. Date of Birth __________________________________________________ Month/Day/Year

8. Citizenship a) Are you a U.S. Citizen? Yes No

(If no, please go to “C”)

b) ____________________________________________ d) Foreign Student Yes No Country of Citizenship c) ____________________________________________ e) Visa type ____________________ f) Expiration Date______________________________________ Permanent resident alien number (if not a U.S. citizen) Month/Day/Year

9. Ethnic Data State and federal laws pertaining to civil rights require the Institute to report ethnic data. A = American Indian D = Asian or Pacific Islander B = White/Non-Hispanic E = Other C = Black/Non-Hispanic S = Hispanic

10. Intent I am enrolling at SBCTI for: College credit only Dual credit

(high school and college credit)

11. Entry Date I plan to start at SBCTI: __________________________________________________________________________________________________ 12. Courses I plan to take the following course(s) at Sensible Business Career and Training Institute COURSE NUMBER COURSE NAME

_______________ _________________________________________________________________________________________________________ _______________ _________________________________________________________________________________________________________ _______________ _________________________________________________________________________________________________________ 13. Education. Please provide the name, city and state of the school you last attend. _________________________________________________________________________________________________________________________ Name City State

14. Emergency Contact _________________________________________________________________________________________________________________________ Last First Relationship

_________________________________________________________________________________________________________________________ Number & Street City State Zip

_________________________________________________________________________________________________________________________ E-mail address

15. Residence Where have you been living for the past 24 months?

(Show month, date and year.) FULL DISCLOSURE REQUIRED

From: _________________ To: _________________ __________________________________________________________________________________________ Month/Day/Year

Month/Day/Year

Address (street, city, state)

Sensible Business Career and Training Institute 36660 Cherry Hill Westland, MI 48185 734.620.9461

From: _________________ To: _________________ __________________________________________________________________________________________ Month/Day/Year

Month/Day/Year

Address (street, city, state)

To be completed by Student (or parent if applicable) PLEASE READ CAREFULLY AND SIGN:

1.) I certify that the information I have provided on this application is accurate, true and complete. 2.) I agree to abide by the policies, rules and regulations of Sensible Business Career and Training Institute.. 3.) I authorize my high school to furnish all academic and personal information requested by the Office of Admissions of Sensible Business Career and Training Institute. 4.) I authorize Sensible Business Career and Training Institute to report my academic progress to my high school. 5.) I understand that my enrollment will be limited to courses approved by Sensible Business Career and Training Institute’s academic advisors. ___________________________________________________________ Applicant Signature, Date of Signing

____________________________________________________________ Parent Signature, Date of Signing (if applicable)

Other Admissions Information Services Available to Students with Disabilities – SBCTI may provide the following assistance for students with disabilities: readers,

note-takers, specialized test taking, tutoring, counseling, accessible parking permits, and referral to community agencies. If you have a disability that requires appropriate academic adjustments, please contact Student Support Services at (734) 620.9461.

Financial Aid Some Students may qualify for tuition assistance through State Programs, Federal Agencies or Private organizations. Note: Additional authorization and documentation may be required. I qualify for Tuition Assistance through:__________________________________________________________________________________________________ To be completed by Assistance Agency or Organization Staff. 1. I have been informed that _________________________________________________________________ plans to enroll for classes at (Student Name)

Sensible Business Career and Training Institute. They have informed me that they wish to participate in the course(s) / program(s) listed in section 12. 2. Please be advised that the above mentioned student has my approval to enroll and has the appropriate funding available to attend class. 3. This student has the following special needs:__________________________________________________________________________________________

_________________________________________________________________________________________________________________________ Agency Representative Signature, Date of Signing

Sensible Business Career and Training Institute approval:

_____________________________________________________ ___________________________________________________________________ Name Title Date

“All tuition and fees paid by the applicant shall be refunded if the applicant is rejected by the school before enrollment. An applicant fee of not more than $25.00 may be retained by the school if the applicant is denied. All tuition and fees paid by the applicant shall be refunded if requested within three business days after signing a contract with the school. All refunds shall be returned within 30 days.”