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General Information
First Name
Last Name
Email
Date of Birth
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Age
Phone Number
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Street Address
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Secondary Street Address
City
Country Of Residence
State/Province
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Zip/Postal Code
Referral Source
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Community-based workforce development, career services, or human services agency
Employment office (local)
Family member friend neighbor, or co-worker
Outreach-Job Fair
Partner Referral
PLA Family
Recruiter
Skilled US Participant/Graduate
Social Media
Other
How did you hear about us?
PLA Schools
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James and Rosemary Phalen Leadership Academy
George and Veronica Phalen Leadership Academy
PLA@93
PLA@103
PLA@48
PLA Virtual Leadership Academy
Promise Prep
Hogan Prep
DCP Harper Woods
DCP Redford
Greater Heights Academy
Kids Care
Eagles Nest
Davis
Bellingrath
Nixon
Higher Institute of Arts and Technology
Trix Academy
Jalen Rose Leadership Academy
Summer Advantage
Other
Referral Source: Other
Applicant Information
Preferred Campus Location
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Kentucky
Ohio
New Mexico
Alabama
Indiana
Massachusetts
Texas (Tarrant County)
Training Location (City/Region)
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Gary
Indianapolis
Do you have a referral code?
Yes
No
What is your referring organization?
St. Joseph's
Goodwill
James and Rosemary Phalen
St Vincent
16Tech
Dress For Success
Safe Passage Housing
Current Student
Other
For "Other", enter the organization here:
Primary Choice for Career Pathway of Interest
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Advanced Manufacturing and Engineering
Construction, Architecture, Welding and Masonry
Advanced Manufacturing and Engineering
Construction, Architecture, Welding and Masonry
CTE (For Current High School Students)
English Classes (ELL/ESL)
Energy, Utilities, Green Technology, Electrical and HVAC
Entrepreneurship
GED/HSE (General Education Development or High School Equivalency)
Healthcare and Social Assistance
Information Technology (IT)
Transportation, Distribution, Logistics Diesel Tech
Advanced Manufacturing
Business, Management, and Administration
Construction, Architecture, and Engineering
Energy, Utilities, and Green Technology
Entrepreneurship
Healthcare and Social Assistance
Hospitality and Tourism
Human Services
Information Technology (IT)
Personal Care and Services
Retail, Sales, and Customer Service
Science, Technology, Engineering, and Math (STEM)
Transportation, Distribution, and Logistics
Advanced Manufacturing
Healthcare and Social Assistance
Information Technology (IT)
Transportation, Distribution, and Logistics
Construction
Advanced Manufacturing
Construction, Architecture, and Engineering
Energy, Utilities, and Green Technology
Transportation, Distribution, and Logistics
Entrepreneurship
Construction, Architecture, and Engineering
Energy, Utilities, and Green Technology
Entrepreneurship
*Some pathways not available in all areas
Primary Choice for Career Pathway of Interest
Please select...
Healthcare and Social Assistance
Construction, Architecture, Welding and Masonry
Transportation, Distribution, Logistics, Diesel Tech
Energy, Utilities, Green Technology, Electrical and HVAC
Entrepreneurship
Advanced Manufacturing and Engineering
Construction, Architecture, Welding and Masonry
CTE (For Current High School Students)
English Classes (ELL/ESL)
Energy, Utilities, Green Technology, Electrical and HVAC
Entrepreneurship
GED/HSE (General Education Development or High School Equivalency)
Healthcare and Social Assistance
Information Technology (IT)
Transportation, Distribution, Logistics, Diesel Tech
*Some pathways not available in all areas
Do you have an secondary choice for a Career Pathway?
Yes
No
Secondary Choice for Career Pathway of Interest
Please select...
Advanced Manufacturing
Construction, Architecture, and Engineering
Energy, Utilities, and Green Technology
Transportation, Distribution, and Logistics
Entrepreneurship
Construction, Architecture, and Engineering
Energy, Utilities, and Green Technology
Entrepreneurship
Construction
Advanced Manufacturing and Engineering
Construction, Architecture, Welding and Masonry
Advanced Manufacturing and Engineering
Construction, Architecture, Welding and Masonry
CTE (For Current High School Students)
English Classes (ELL/ESL)
Energy, Utilities, Green Technology, Electrical and HVAC
Entrepreneurship
GED/HSE (General Education Development or High School Equivalency)
Healthcare and Social Assistance
Information Technology (IT)
Transportation, Distribution, Logistics, Diesel Tech
Advanced Manufacturing
Business, Management, and Administration
Construction, Architecture, and Engineering
Energy, Utilities, and Green Technology
Entrepreneurship
Healthcare and Social Assistance
Hospitality and Tourism
Human Services
Information Technology (IT)
Personal Care and Services
Retail, Sales, and Customer Service
Science, Technology, Engineering, and Math (STEM)
Transportation, Distribution, and Logistics
Advanced Manufacturing
Healthcare and Social Assistance
Information Technology (IT)
Transportation, Distribution, and Logistics
Some Pathways not available in all areas
x
Secondary Choice for Career Pathway of Interest
Please select...
Healthcare and Social Assistance
Construction, Architecture, Welding and Masonry
Transportation, Distribution, Logistics and Diesel Tech
Energy, Utilities, Green Technology, Electrical and HVAC
Entrepreneurship
Advanced Manufacturing and Engineering
Construction, Architecture, and Engineering
CTE (For Current High School Students)
English Classes (ELL/ESL)
Energy, Utilities, Green Technology, Electrical and HVAC
Entrepreneurship
GED/HSE (General Education Development or High School Equivalency)
Healthcare and Social Assistance
Information Technology (IT)
Transportation, Distribution, and Logistics
*Some pathways not available in all areas
I have a/am a:
Please select...
Current High School Student
High School Diploma
GED (General Educational Development) or HSE (High School Equivalent)
Associate's Degree
Bachelor's Degree
Master's Degree
None of the Above
Are you a Veteran of the U.S. Armed Forces?
Please select...
Yes, I am a Veteran
No, I am not a Veteran
I prefer not to disclose
Have you previously applied to enroll into Skilled US/PLA University?
Please select...
No, this is my first time applying
Yes, I have applied before
Are you connected to a current or former scholar or staff member of a PLA school?
Please select...
Yes, I am a relative of a current scholar
I am a relative of a PLA Staff Member
I am a PLA Staff Member.
No. I am not related to a PLA scholar or staff member, but would like to enroll.
What is the name of the PLA school?
Please select...
James and Rosemary Phalen Leadership Academy
George and Veronica Phalen Leadership Academy
PLA@93
PLA@103
PLA@48
PLA Virtual Leadership Academy
Promise Prep
Hogan Prep
DCP Harper Woods
DCP Redford
Greater Heights Academy
Kids Care
Eagle’s Nest
Davis
Bellingrath
Nixon
Higher Institute of Arts and Technology
Trix Academy
Jalen Rose Leadership Academy
Summer Advantage
Other
What is your Gender Identity?
Please select...
Male
Female
Non-Binary
Prefer Not To Say
Select all Race/Demographics that apply
American Indian or Alaska Native
Black or African American
Native Hawaiian or Other Pacific Islander
White
Asian or Asian American
Middle Eastern or North African
Hispanic or Latino/a/x
Prefer not to say
The following demographics questions help Skilled US access grant funding when/if available and are, therefore, required. Answers do not affect admissions decisions. Please select all that apply
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Are you receiving Supplemental Nutrition Assistance Program (SNAP) Benefits?
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No
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