Application For Admission

I understand that in completing this qualification form, the School is under no obligation to accept me, nor am I under any obligation to the School of Automotive Machinists & Technology. I agree to furnish all required documents for admission and certify that the information contained in this application for admission is correct.

WHICH PROGRAM ARE YOU INTERESTED IN?
Block Machining
Head Machining
CNC Machining
EFI Tuning
Associates Degree
NAME:
LAST
FIRST
MIDDLE INITIAL
ADDRESS:
STREET
APT #
CITY
STATE
ZIP
PHONE:
CELL:
MESSAGE PHONE:
BIRTH DATE:
Male
Female
VETERAN:
YES
NO
US CITIZEN:
YES
NO
DRIVER LICENSE NO.:
STATE:
SOCIAL SECURITY NO.:
PARENTS NAME:
PHONE:
IN CASE OF EMERGENCY NOTIFY:
NAME
RELATIONSHIP
ADDRESS
CITY
STATE
ZIP
PHONE

Check One:
Married Single Divorced Seperated
YESNO
EMAIL:
YES NO
Do you live with your parents?
YES NO
Are you a high school graduate? If yes, date of graduation
High School:
City/State:
YES NO
Do you have a GED?
If yes, name of center:
City/State:
YES NO
Attended any school past high school? Name of school
City/State :
Program:
YES NO
Do you have a vocational handicap? If yes, please describe briefly
YES NO
Have you ever received any type of financial aid?
If yes, what school
Type of Aid
YES NO
Have you ever been convicted of a feIony? (Conviction will not be an absolute bar to enrollment)

Present Employer
Phone
List Two References:
NAME
ADDRESS
PHONE
RELATIONSHIP
NAME
ADDRESS
PHONE
RELATIONSHIP
If you are accepted for training, what starting date would you prefer?
How will tuition be paid?
Financial Aid Other
Do you learn best by:
Watching Others
Reading
Hands-On
How would you ”classify your ability to take instructions?
Excellent
Good
Average
Poor
How is your ability to concentrate?
Excellent
Good
Average
Poor
Write in one paragraph, why you would like to attend the School of Automotive Machinists & Technology:
How did you hear about the School of Automotive Machinists & Technology?

SAM Tech SUPPORTS A DRUG-FREE ENVIRONMENT

In support of drug-free environment, and as a condition of my acceptance to the School of Automotive Machinists & Technology, I agree to participate in the School's Random Drug Testing Program. I understand that a publication fully explaining the Random Drug Testing Program will be made available to me during my new student orientation activity at the campus. For additional information, contact the School Director.

I hereby give permission for my grades to be released to my parents or sponsoring agency.
I hereby give permission for my photograph and scholastic information to be released as deemed appropriate by SAM Tech.
I hereby affirm that the above information is true and complete, and I agree to comply with SAM Tech Drug-Free Policy.

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