Apply Now

To apply please print a copy of this form, fill it out, and submit via fax or mail to the address at the bottom of this page.

You can also call the numbers below to enroll by phone or to schedule a visit to our facility.

Personal Data

Name
Address Line 1
Address Line 2
City, State & Zip
Work phone	Home phone
Fax	Email
Social Security Number	Date of Birth

Emergency Contact Information

Name	Relationship
Home Phone	Work Phone

Educational Background
Please check all that apply

HS Diploma ___	GED ___	Trade School ___	College credits/degree ___
Other Training
Licenses Held

Work History
Please include your three most recent jobs.

Current Employer	Job Title	Phone
Employer	Job Title	Phone
Employer	Job Title	Phone

If you are unemployed, how many weeks/months have you been employed? ____
Are you collecting unemployment? Yes ___ No ___
Did your employer close down? Yes ___ No ___

Shirt Size ..S 36"x38"___ M 40"x42"___ Lg 44"x46"___XL 48"x50"___2XL 52"x54"___

Military Background

Are you a veteran? Yes ___ No ___
If yes, If yes, how many years did you serve? ___

Health Background

Please provide all information that applies to you.

Medical problems

Prescription medications

Corrective eye glasses or contacts

Physical or learning disabilities

General Information

List all the ways you learned about Modern Welding.

Do you think you are mechanically inclined? Yes ___ No ___
List some of your hobbies___________________________________________
Are you interested in day classes? ___ evening classes? ___
What month are you ready to start training? ____________________
Do you have a valid NYS drivers license? Yes___ No ___
Have you ever been convicted of a felony? Yes___ No___
Have you ever been expelled or dismissed from another College, University, or Trade School for disciplinary reasons? Yes ___ No ___
Have you previously applied to Modern Welding School? Yes ___ No ___
Have you previously attended Modern Welding School? Yes ___ No ___

Statement of Purpose

What goals do you plan to achieve by attending school here @ Modern Welding School?

______________________________________________________________________

What characteristics or skills do you have that are most valuable, and how will they help you on your way through school?

______________________________________________________________________

Complete and Sign

I do hereby certify that the information provided here is true and accurate to the best of my knowledge. If accepted by Modern Welding School I agree to complete the requirements of the training program offered and follow the rules and regulations of the school.

APPLICANT'S NAME	TODAY'S DATE
APPLICANT'S SIGNATURE

To be Completed by Modern Welding Admissions Department
Accepted for start date	Denied admissions
Reason for denial
Admissions Representative	Date

Helping shape the world we live in since 1936.
Home		Back

Modern Welding School, Inc.
1842 State Street
Schenectady, NY 12304 Map
Phone 518-374-1216 Toll-Free 800-396-6810
FAX 518-374-1288
Email more@modernwelding.com
www.modernwelding.com