Student Self Enrollment
Employee Number
*
First Name
*
Last Name
*
Supervisor
*
General Foreman
Classification
None
Foreman
A Lineman
C Lineman
Equipment Operator
Groundman
B Lineman
Other
Email
* (e.g. name@domain.com)
Ethnicity:
None Selected
Caucasian
Black
Hispanic
American Indian
Asian
Other
Education:
None Selected
High School Student
High School Graduate
GED
Other
Temporary Waiver
Student Is a Veteran?
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Captcha
*