Austin Career Institute Application

First Name:*
Last Name:*
E-Mail:*
Mobile:*
Program:*

Contact Information

Address:*
Unit/Suite #
City:*
State:*
Country:*
ZipCode:*
Level of Education*
Birth Date:*
Social Security Number*
Ethnicity*
Gender*
Are you currently employed?*
Are you a resident alien*
Citizenship*
Military Veteran*
Currently Active Duty Military*
Military Dependent*
Is this your first time attending a college*

Please provide the contact information to at least two emergency contacts:

Emergency Contact #1 - Full Name*
Emergency Contact #1 - Phone*
Emergency Contact #1 - Relationship*
Emergency Contact #2 - Full Name*
Emergency Contact #2 - Phone*
Emergency Contact #2 - Relationship*
Emergency Contact #3 - Full Name
Emergency Contact #3 - Phone
Emergency Contact #3 - Relationship

Student Loans Grants Laws Data Family Educational Rights and Privacy Act (FERPA)

Austin Career Institute can share information, regarding:

  • Job Status
  • Attendance/Graduation Status
  • Certification Status
  • Financial Status

according to FERPA

FERPA Individual #1 Consent Level

Individual #1 - Full Name
Job Status Consent
Certification Status Consent
Attendance/Graduation Status Consent
Financial Status Consent
All Records
Individual #1 - Phone
Individual #1 - Relationship

FERPA Individual #2 Consent Level

Individual #2 - Full Name
Job Status Consent
Certification Status Consent
Attendance/Graduation Status Consent
Financial Status Consent
All Records
Individual #2 - Phone
Individual #2 - Relationship
How did you hear about us?*
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