Conversations That Matter
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| The jefferson Clemente
Course in the Humanities Application for 2018 Clemente Course: “Conversations That Matter” March 19 - May 30, 2018 Mon/Wed, 6-8:30 PM Pope Marine Building, Port Townsend WA to apply: 1) Email: jeffcoclemente@gmail.com, or call/text Arendt Speser (360-774-6635) 2) fill out this application completely and bring it with you to the interview Name ______________________________ Address ______________________________________ City _______________State ______ Zip ___________ Home phone ____________________ Other phone___________________ Marital status: ___Single ___ Married ___Separated ___Divorced ___Widowed Do you have children? ______ If so, how many? ______ Age(s) _____ _____ _____ _____ _____ Would you need childcare to attend classes? _______ Would you need help with transportation? _________
If Other, please identify ___________________________________________ Education: Highest grade completed_______ Are you currently in school?______ If so, which school? ____________________________ If not, are you a HS graduate? ____________ G.E.D. recipient? __________ Working on your G.E.D.?_________ Have you ever attended college?____ If so, when? For how long? ____Which college? _____________ Why did you stop? ________________________________________________________________ Employment/training: Skill/Occupation ____________________________________________ ___ Employed full-time ___ Employed part-time ___Unemployed ___Volunteer ___ Interning Entitlements (such as TANF, SSI, etc) ________________________ Enrolled in other programs (school, recovery, etc.): Yes____ No _____ Names of Programs (Optional)_______________ U.S. Citizen?______ Permanent resident?_______ If not, where were you born?________________ On A separate sheet of paper, please write About yourself, your interests, and why you want to attend THE CLEMENTE COURSE. Thank you. We look forward to hearing from you soon! Directory: 2018 2018 -> Epa vehicle class 2018 -> For Release: Monday, Jan. 9, 2017, 12: 01 a m. Est 2018 -> Joints of the vertebral column 14. 01. 2014 2018 -> 2018 National apawli signature Program Application 2018 -> Yarraville West Primary School 2018 -> Request for petitions for 2018 -> Odyssey Travel Program Dancer Information Summer 2018 #SpreadtheWord!! 2018 -> New Examiner Application Form 2018 Award Cycle 2018 -> December, 2014 table of contents 2018 -> Atlantic City Download 13.65 Kb. Share with your friends:
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