MCC General Intake and Funding Application

Personal Information





Encrypted for your Privacy

Please use the following date format mm/dd/yyyy
Participant Personally-Identifiable Data Collection Notification

The collection of this information helps to track the long-term success of this training program. Your personal information is encrypted and will be kept confidential. It will not be shared with any outside agencies other than those involved with the support or oversight of the funding grant received by Monroe Community College. Your information will never be sold or shared with third party agencies through your participation in grant supported training activities. 


In addition to requesting a range of information from project participants, including demographic information, the use of your Social Security Number is also requested in order to access wage and employment information through state data bases. Although you cannot be denied service for failure to provide your Social Security Number, we strongly encourage you to do so in order to enable the project to quantify specific employment-related outcomes. Your personal information will be kept confidential.



Address Information




Demographic Information



Educational Background






Americans with Disabilities Act Information 
In accordance with the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973, MCC Economic & Workforce Development Center/Corporate College ensures that services, activities, facilities, and academic programs are accessible to and usable by qualified students with disabilities.



Employment Information







If you have a resume, please upload it here
Acknowledgement
Upon course completion, Monroe Community College will distribute an Outcomes Survey to all course participants. As a condition of receiving funding to complete this course, your response to this survey is requested. The Outcomes Survey will take less than 5 minutes to complete, and will have an important impact on future student experiences.

Program of Interest
MCC offers Workforce Certificates, Academic Certificates, and Associate Degrees in the following areas. Please select the program you're interested in pursuing.