Student Self Enrollment
Employee Number
*
First Name
*
Last Name
*
Supervisor
*
General Foreman
Classification
None
C Lineman
A Lineman
Groundman
B Lineman
Equipment Operator
Other
Foreman
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?
Check here if yes
Captcha
*