Thank you for your interest in GRCC's Apprenticeship programs. Once this form is submitted, please connect with your Apprenticeship Coordinator to fill out the Grade/Attendance Release Form and submit it to email@example.com. Contact Information First Name Last Name Phone Number Address Apt. Number City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code County Personal Information Date of Birth Gender (used for reporting purposes only.) Predominant ethnic background (used for reporting purposes only.) - None -African-American (non-Hispanic)Asian/Pacific IslandersCaucasian (non-Hispanic)Latino or HispanicNative American or AleutOtherPrefer not to disclose Program Information Which semester would you like to begin the program? - Select -FallWinterSummer Which academic year would you like to begin? Apprenticeship Trade Employer Who should receive the tuition bill? My employer. Me. Signature Signature By submitting this form, you certify the information included is true and acknowledge your academic plan code will be changed to indicate Apprenticeship Code 954, which is not eligible for financial aid. I agree I agree.