Application Form

Thinking out the Box
helping technology make sense

EQUIPPING THE TECHNICALLY UNPREPARED..THE FINANCIALLY CHALLENGED...and the ECONOMICALLY UNDERSERVED!

Application for Acceptance

If you would like to see if you qualify for our FREE Tuition Assistance Program, then please complete the below form.

PLEASE NOTE: Not everyone qualifies for free tuition, but we do not turn anyone down for our training programs.

Program of Interest

GED (High School Diploma)	Other: (Business or Entrepreneurship)
CBT (Computer-Based Training)

Your Details

Title:
First Name:
Middle Name:
Last Name:
Personal Email:
Re-type your email address for verification:

Contact Information

Address:
Address 2:
City:
State:
Zip:
Daytime Telephone:
Evening Telephone:
Cell phone:

Marital Status

Divorce				Single
Married				Widowed
Separated

Race

American Indian or Alaska Native		Native Hawaiian or Pacific Islander
Asian	White
Black or African American	Other: (specify below)
Hispanic or Latino

Gender

Male	Date of Birth: (mm/dd/yyyy)
Female

Highest Education Level Completed

High School / GED	Graduate Studies
Vocational / Technical School	Masters
Some College / University	Other: (specify below)
BA / BS
Please, type any additional comments or questions here.
We want to thank you so much for expressing interest in our programs and one of our admissions counselors will contact you regarding the status of your application.

S.E.E.D.© Technology Center, LLC
P.O. Box 23486 · Columbia, SC 29224 · USA
866.233.1407 · 803.667.4470 · 803.667.4446/fax
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