ENVISION Business & Computer School, LLC

Thank you for your interest in ENVISION.  By submitting this application you are taking the first step in fulfilling your career goal!

Pre-application Process

Items marked with an * are required.

Personal Information
Last Name*:
First Name*:
Middle Name:
Gender:	Select Male Female
Address*:
City*:
State*:	Alaska Alabama Arkansas Arizona California Colorado Connecticut Washington D.C. Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missourri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming International
Zip Code*:
Date of Birth:	/ /
Home Phone*:
Alternate Phone:
Email*:
Best time to contact:

Program Desired
Programs of Study*:	Select Computerized Accounting General Clerical Receptionist Administrative Assistant Certified Nurse Assistant Medical Office Assistant Medical Billing Clerk Legal Office Assistant Secretarial Science A+Certification Website Development
Day or Evening:	No preference Day Evening

Educational Background
Do you have a High School Diploma?	Select Yes No Pending
Year of actual or anticipated graduation (if applicable):
High School Attended:
Address of High School:
City of High School:
State of High School:	Alaska Alabama Arkansas Arizona California Colorado Connecticut Washington D.C. Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missourri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming International
Zip Code of High School:
Do you have a GED certificate?	Select Yes No Pending
Year GED was earned or is anticipated (if applicable):
If not in Connecticut, give state or country where GED was earned:

Additional Info
Admission Status:	Select Currently in High School New to EB&C ENVISION, have attended other career school(s)
Employment Information:	Select Employed full-time Employed part-time Unemployed

Comments:

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