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Applicant Information Form
Name
First
Middle
Last
Date of Birth
Month
Day
Year
Gender
Female
Male
Another Gender or Prefer to Not Disclose
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Türkiye
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Email
Mobile Number
High School Graduation Year (If Applicable)
High School Attended
Year GED obtained (If Applicable)
Have you taken either the ACT or SAT exam?
Yes
No
Are you a U.S. military veteran or currently serving?
Yes
No
Why are you interested in pursuing a career in the trades? (Check all that apply)
(Required)
To start a career quickly
Lower cost compared to traditional college
Interest in hands-on or technical work
Job stability and high demand in skilled trades
Better protection from AI automation
Less risk of jobs being outsourced
Recommendation from family/friends
Desire to change careers
Other
If other, please specify.
(Required)
Program(s) of Interest (Check all that apply)
Automotive
Carpentry
Collision Repair
Diesel
Electrical
HVAC
Truck Driving
Welding
How did you hear about Rosedale Tech (Check all that apply)?
Online Search
Social Media Advertisement
Radio Commercial
Internet (Google Search)
Online Web Advertisement
Television Commercial
High School Presentation
Referral
Career Fair
Internet (i.e. Banner ads, YouTube video, etc.)
Other
If referred, who referred you?
How do you catch up on news/obtain information (check all that apply)?
TV Shows
Podcasts
Social Media
Radio
Websites
Please list some specific examples of places you obtain information from
How do you listen to music?
Radio
Streaming (ex. Pandora, Spotify, YouTube)
Satellite Radio
Other
I do not listen to music
What genre of music do you typically listen to?
Pop
R&B
Alternative
Indie Rock
Country
Hip Hop
Oldies
Rap
Rock
EDM
I do not listen to music
Other
What social media platforms do you use?
Facebook
Instagram
Snapchat
Twitter
TikTok
YouTube
Pinterest
I don't use social media
Distance Education Questionnaire
Do you have access to or can obtain a reliable computer or device for online learning? Please refer to the Bring Your Own Technology Policy for an outline of device requirements.
(Required)
Yes
No
Do you have stable internet access for streaming videos and participating in virtual classes?
(Required)
Yes
No
Do you have a quiet and comfortable space for studying and attending online sessions?
(Required)
Yes
No
Have you previously participated in any form of online learning?
(Required)
Yes
No
If you answered yes to the above question, do you feel comfortable with your ability to be successful utilizing online training?
(Required)
Yes
No
Are you motivated to learn independently?
(Required)
Yes
No
Can you allocate sufficient time for coursework and assignments?
(Required)
Yes
No
Do you feel comfortable utilizing technology?
(Required)
Yes
No
Do you feel comfortable using the internet?
(Required)
Yes
No
Do you feel comfortable using email?
(Required)
Yes
No