Form - 11/2018
Please print clearly.
Name
Address
Employment Status
¨ Unemployed ¨ Employed
Location
MA State Resident
¨ Yes ¨ No Can you Provide Citizenship/Work Authorization? ¨ Yes ¨ No
Are you currently receiving assistance?
¨ SNAP ¨ TAFDC ¨ SSI ¨ Unemployment Insurance ¨ Other:
Highest Level of Education
¨ 9
th
-12
th
grade, no diploma ¨ High School Diploma ¨ GED/High School Equivalency ¨ Some college, no degree
¨ Associate degree:
Which training program(s) are you interested in? Check all that apply.
¨ Certificate in Hospitality Core Skills (42 hours) ¨ Certificate in Culinary Core Skills (39 hours)
¨ Certificate in Hospitality Supervision and Management Core Skills (123 hours)
City
Title
¨ Not receiving assistance
¨ Bachelor degree or higher:
State Zip Code
Phone/Cell Email
Certificate Courses
Hospitality Core Skills for Front-of-the-House Operations
42 total hours
Introduction to Hospitality 12 hours
Customer Engagement 21 hours
Steps of Service 3 hours
Intro to Wine 6 hours
Certificate in Culinary Core Skills for Back-of-the-House Operations
39 total hours
Introduction to Hospitality 12 hours
ServSafe Certification 8 hours
Knife Skills 3 hours
Food Prep 12 hours
Externship (Optional)
160 hours
2-month, paid externship at a participating company
Pre-requisite is at least one of the following completed certificates:
Hospitality Core Skills 42 hours
Culinary Core Skills 39 hours
Certificate in Hospitality Supervision and Management Core Skills
123 total hours
Introduction to Hospitality 12 hours
Customer Engagement 21 hours
Business Basics for Hospitality 30 hours
Hospitality Leaders 30 hours
HR for Hospitality 30 hours
