Thank you for your interest!

Initial Screening (additional requirements dependent on campus and course)

	Yes	No
Are you 18 years or older?
Do you have a High School diploma/equivalent or higher?
Are you authorized to work in the U.S.?
Do you have a passion for technology?
Will you be available to take a role in tech immediately following training?
Have you experienced any challenges launching a career in technology?

What challenge(s) have you experienced/currently experiencing launching a career in technology?

Financial constraints due to the cost of tech trainingHave tech experience but have struggled to secure a tech roleTime commitmentOther challenge(s)Select all that apply

What other challenge(s) have you experienced/currently experiencing launching a career in technology?

Limit response to 250 characters.

Thank you for your interest.

Based on your responses for the previous page, you do not meet one or all of the following minimum learner eligibility requirements to enroll in a Per Scholas course:

At least 18 years of age.
Attained at least a HS diploma/equivalent or higher.
Authorized to work in the U.S.

If your situation changes, please resubmit a form. Best of luck on your future endeavors!

Contact Information

What is your preferred email address?

Please note that this email will be used by the Per Scholas team to contact you about next steps in the admissions process. We highly recommend using the same email for all communications with Per Scholas staff members.

Please confirm your preferred email address

Confirm Email Message

What is your mobile phone number?

Do you want to receive text message updates about Per Scholas training and opportunities at the phone number provided?

YesNoYour consent is optional and will not impact your eligibility. Message and data rates may apply. Reply HELP for help and STOP to cancel.

What is the street address of your primary residence?

What city do you live in?

What state do you live in?

Per Scholas is not accepting applications from non-U.S. residents at this time.

What is the County or County Equivalent that you live in?

Please use this resource if unsure of your county or county equivalent: https://www.whatcountyamiin.com/

What is your Zip/Postal Code?

Household & Personal Income

Including yourself, how many people live in your household?

What is your annual household income?

Combined incomes of all family members in your household or place of residence that includes all forms of earned income; e.g., wages, salaries, tips, and other taxable employee pay. This does not include savings or inheritance funds. This data is used to calculate our org-wide average learner household income and may be shared with our philanthropic supporters, allowing us to continue to provide no-cost training. Please provide in U.S. Dollars.

Are you currently employed?

YesNo

Have you ever worked for pay?

YesNo

When did your last employment end?

Format: mm/dd/yyyy

How much total income did you, personally, earn in the past year?

If you only know your hourly pay, please use this formula to calculate your annual pay: your hourly pay x hours worked each week x 52.

Per Scholas follows all ADA (Americans with Disabilities Act) policies and procedures regarding accessibility and accommodations. The ADA defines a person with a disability as a person who has a physical or mental impairment that substantially limits one or more major life activities. Do you anticipate needing ADA accommodations in the Admissions Process?

YesNoADA accommodation requests typically need to be supported by Medical documentation. Accepted documentation includes but is not limited to a Medical note, IEP, or 504 and must be provided by a qualified evaluator.

If yes to above, what type of accommodations?

Only let us know about Accommodations needed for the Admissions Process (for example, extra time on Admissions Assessments). Once accepted into training, all learners are asked about ADA Accommodations needed during training. Your response to this question will not impact Admissions Decisions.

Where did you FIRST hear about Per Scholas?

Where did you specifically hear about Per Scholas?

What is the name of the referring Agency, Institution or Community Based Organization?

Which Indianapolis Goodwill Excel Centre Location?

Where else did you hear about Per Scholas?

With what you know about Per Scholas today, how confident are you that Per Scholas is a good fit for you and your goals?

How likely are you to move on to the next step in enrollment with Per Scholas?

By submitting this form, you certify that everything you’re submitting is true and accurate to the best of your knowledge. By providing your contact information (including cell number) and clicking “Agree & Submit” below, you agree that Per Scholas may contact you about our relevant content, products, and services via email, phone and text communications.

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Per Scholas Training Eligibility Form

Initial Screening (additional requirements dependent on campus and course)

Thank you for your interest.

Choose a location for
Your Course

Thank you for your interest!

Per Scholas Training Eligibility Form

Initial Screening (additional requirements dependent on campus and course)

Thank you for your interest.

Choose a location for Your Course

Choose a location for
Your Course