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The Tennessee Technology Center at Memphis provides an equal opportunity for all persons without regard to their race, sex, color, religion, age, national origin, or handicap in all matters of admission, educational programs, employment, and student activities.

Fill in all fields of the application below. We will E-mail, or contact you, with information pertaining to your application as soon as Student Services reviews the application form.

Salutation:

Last Name: *

First Name: *

M.I.:

Address:

P.O. Box:

City:

State:

Zip:

Phone 1:

Phone 2:

Birth Date:

Email:

Highest Grade Level Completed:

Last School Attended:

Date Graduated or Left:

Have you attended TTC Memphis before?:

Occupational Objective:

To earn a certificate or diploma in the selected program and obtain gainful employment.

To upgrade skills and technical knowledge in my present job and/or take a refresher course in the selected program. (Supplemental Certificate).

Persons desiring to enroll in any Tennessee Technology Center must declare an occupational objective. Please read the statements below and indicate your objective by selecting the name of the training program in which you plan to enroll.

Program of Interest:

Other:

Schedule Preference:

Day

Night

Full-time

Part-time

Date you are available to begin training: :

Are you eligible to register for the Federal Draft?:

Yes

If yes, have you registered? :

Are you a U.S. Citizen?:

If no, are you a permanent resident of the U.S.?:

Alien Registration Number:

I certify the above information to be correct and complete. : *

I understand that withholding information requested in this application or giving false information may make me ineligible for admission to the Tennessee Technology Center at Memphis. With this in mind, I certify the above information to be correct and complete.

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