Workforce Equity Initiative Contact Form

WORKFORCE EQUITY PROSPECTIVE STUDENT FORM

Please enter your contact information below with your interests and resources needed to complete the program of interest. Once finished click submit. Our staff contact you to discuss your options.

Name*

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number

Alternate Phone Number

What are you interested in?

Please check all that apply.

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Certified Nursing Assistant
Forklift Training
Heating, Ventilation, Air Conditioning and Refrigeration
LPN
Medical Assistant
Phlebotomy
Welding

What resources would you need in order to complete the program?

Please check all that apply.

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Financial Aid
Food Needs
Transportation

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Workforce Equity Initiative Contact Form

601 James R. Thompson Blvd,
East St Louis, IL 62201

618-874-6594

WORKFORCE EQUITY PROSPECTIVE STUDENT FORM

East St
Louis

Fire
Science

PSOP
Campus

Scott Air
Force Base

SW Justice &
Workforce Dev

Other
Campus