Pre-Apprenticeship Application
Contact Information: Please tell us the best way to contact you
Age:
Zip:
Name: Email:
Home Phone: Cell Phone:
Address: City:
Other Contact (family member or friend who knows how to contact you if the above changes)
Phone:
Relationship (friend, parent, etc)
Email address (if different than above):
Information regarding current DVC status
Student ID:
Receiving
Financial Aid?
Yes No
Currently Enrolled?
Yes No
Background Information (optional): Please check any of these that apply to you
CalWORKs
Receiving disability
Emancipated Foster Youth
Receiving Unemployment
Have attended college before
Currently Working Hours per week
Receiving One Stop or WIA assistance
Currently/formerly homeless
Formerly incarcerated
Mandatory Information
I have completed the DVC application: Yes No
I have a High School Diploma or GED:
Yes No
I have taken: Math Assessment score ___________________
English Assessment score ___________________
CESLA (ESL) Assessment score ___________________
I have a valid CA Driver’s License: Yes No
I am interested in the following program: Trade: ____________________
Signature __________________________ Date _______________________
Return by mail to: Joe Valdez, Diablo Valley College, 321 Golf Club RdPleasant Hill, CA
94523; Office: 925-969-2368 email to: jvaldez@dvc.edu
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