Apply Online

To best serve you during your visit, we ask that you answer the questions on this form as fully as you can. All information will be held in strict confidence and will be used to determine your aptitude for any of our career focused programs. Great Lakes Institute of Technology does not discriminate against any person because of race, color, religion, sex, disabilities, age, national origin, or ancestry regarding admission to programs.

Personal Information


*First Name *Last Name
Middle Name Maiden Name
*Address *City
*State Zipcode
*Home Phone Cell Phone
May we text your cell phone?
*Email Address Date of Birth
Driver's License # Driver's License State
Gender
Hispanic or Latino Ethnicity
U.S. Veteran? Citizenship
Emergency Contact Name Relationship
Emergency Contact Phone

Background


Have you ever been convicted or pleaded guilty to a crime?
If yes, please explain:

Program of Interest


I am applying for:

Education Information


GED - Year Completed State Where Completed
High School Diploma - Year Graduated:
High School Name City / State


Disclaimer

As part of the admission requirements, there is a $25.00 Application Fee due should you choose to apply to the school. If you opted-in to receive SMS/Text messages on your cell phone, it will only be used to send you communication pertaining to your application/enrollment. Please be aware your cell phone carrier may charge a fee for delivery of messages based on your current calling plan. Your number will not be given to any third party. You may opt-out in writing at any time.

Class sizes are limited to a maximum number of students per program and will be closed to enrollment when that number is reached. Enrollment is granted on a first-come first-serve bases only to registered applicants who have completed all admission requirements. Applicants who have not become enrolled in a class that has been closed have the option to register for a future class.

By signing this application, I authorize investigation of all statements contained in this application. I also authorize the school to review my financial aid history. I understand that misrepresentation or omission of facts called for is cause for rejection of admission, or dismissal, if enrolled.