LSC-NORTH HARRIS APPLIED TECHNOLOGY APPLICATION

INSTRUCTIONS: Please answer all questions. If a question does not apply to you, please choose "N/A".
PART I

APPLICANT INFORMATION



EDUCATION

* Did you graduate?
If GED or High School equivalency, check here
Did you graduate?
Did you graduate?

EMPLOYMENT INFORMATION (FOR THE PAST FIVE YEARS)





EMERGENCY CONTACT


MILITARY SERVICE


REFERENCES


DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to acceptance into the program, I understand that false or misleading information in my application or interview may result in my release.
* I agree with the terms and conditions as stated above.

ESSAY QUESTION

PART II
0/250 words
* Indicates Response Required