Application For Admission Application For Admission Please enter all information. Fields marked with an * are required.

Personal Information

* Last Name	* First	M.I.
Maiden Name (if applicable)

* Address
* City	* State	* Zip	* County

* Home Telephone (please include Area Code)	Work Telephone (please include Area Code)
Cell Telephone (please include Area Code)	** E-mail Address

* Birth Date (mm/dd/yyyy)

State of Birth

Place of Work

Hours

Agency

Branch

Contact

* Marital Status
Single	Married	Divorced	Separated	Widowed

* Predominant Ethnic Background (to be used only for federal reports)
Hispanic or Latino	American Indian or Alaska Native	Asian	Black
Native Hawaiian or other Pacific Islander	White	Two or more races

* Sex Male    Female

* U.S. Citizen Yes    No

 

Parent/Guardian/Spouse Information

Parent/Guardian/Spouse Last Name

First

Address
City	State	Zip	County

Home Telephone (please include Area Code)	Work Telephone (please include Area Code)
Occupation

 

Educational Background

High School
Vocational - Technical School
Address
City	State	Zip	County

* Date of graduation/Expected graduation (mm/yyyy)
If you did not graduate from high school, do you have a G.E.D.?	Date of G.E.D. (mm/yyyy)	State

Please list all educational institutions attended beyond high school:
Name of Institution & Address	Dates (From, To)	Diploma or Degree
Name of Institution & Address	Dates (From, To)	Diploma or Degree

 

Housing/Transportation

While attending YTI, will you:
live at home and commute?		live with a relative or friend?
need assistance finding housing?		need assistance with transportation?

 

Program Information

* After selecting the campus you plan to attend, please select the program that you are applying for
* Primary Campus:	Please choose a campus... York Lancaster Mechanicsburg Altoona Motorcycle Technology Center
* Program:

* Classes Held In
Morning	Afternoon	Evening

 

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