Student Application Student Application Step 1 of 4 0% BASIC INFORMATIONFirst Name (Legal Name)*Middle NameLast Name (Legal Name)*Email Address*Confirm Email Address*Other Email AddressGender*MaleFemalePrefer Not to AnswerDate of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920PHONE CONTACT INFORMATIONPrimary Phone*Secondary PhoneOther PhoneEMERGENCY CONTACT INFORMATIONName*Relation*Primary Phone*Secondary PhonePHYSICAL ADDRESS CONTACT INFORMATIONAddress* Mailing Address Mailing Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code ETHNICITY/DEMOGRAPHICSF.I.R.S.T. Institute does not discriminate regarding sex, age, race, color, disability, national origin, creed and/or religion. The training offered by F.I.R.S.T. Institute may have stamina or mobility requirements that may be different from other occupations. Federal law requires that institutions of higher education gather the following information regarding the ethnicity and race of its students and employees. Your individual information will be kept strictly confidential. The information is intended solely for federal statistical and reporting purposes and will not be used as a factor in the admissions process. Select one or more of the following races* American Indian Asian Black or African American Hispanic or Latino White Other Prefer Not to Answer PREVIOUS EDUCATIONApplicants must have graduated with a standard high school diploma or have passed the GED by their start date. Evaluation of official transcripts and GED test scores will be requested to verify eligibility to attend.What level of high school did you complete?*Still in high schoolCompleted high school with a diplomaReceived a GEDNone of the aboveName of high school or training center* School / Training Center Name City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Date of Completion*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Is English your primary language?*YesNoApplicants whose primary language is not English must demonstrate the required level of language proficiency. If "no" what is your primary language?*CHOOSE YOUR PROGRAM* Recording Arts & Show Production Digital Filmmaking & TV Broadcast Graphic Design & Web Development Criminal History By submitting this application, you agree to immediately notify the school should there be a change of circumstances that affects the accuracy of your answers in this section between the date you submit your application and your first day of classes.Have you ever been convicted of a criminal offense, found guilty, or entered a plea of guilty or no contest, regardless of adjudication?*YesNoList all the offenses and/or pending charges, the date of each offense/charge, and the date of each conviction/adjudication. Also, describe the circumstances surrounding each offense/charge and if you wish, you may provide a statement as to why you believe this information should not be cause for concern about the safety of the F.I.R.S.T. Institute Community.If yes, please list all offenses and pending charges. WRITING SECTIONThe "Writing Section" is a required and an important part of your application for admission. Content as well as spelling, grammar, and punctuation are considered. *Tip – Write like it matters, not like you’re texting.How did you hear about F.I.R.S.T. Institute?*Do you have any experience in this industry? If yes, please explain.*What are your career goals in 3 to 5 years after graduation?*What would prevent you from enrolling in school?*Why do you feel you are a good fit for F.I.R.S.T. Institute?* Education Is Power!Going to school with a friend or family member is a great way to ensure everyone is successful. Please refer up to 3 people to change their lives towards a successful career in this exciting industry! (This section is voluntary, not required) 1. Name First Last PhoneEmail Program Of InterestPlease Select ProgramRecording ArtsFilm & VideoWeb & Graphic Design2. Name First Last PhoneEmail Program Of InterestPlease Select ProgramRecording ArtsFilm & VideoWeb & Graphic Design3. Name First Last PhoneEmail Program Of InterestPlease Select ProgramRecording ArtsFilm & VideoWeb & Graphic DesignBy submitting this form, I certify that the statements I have made in this application are complete and true to the best of my knowledge. If accepted, I agree to abide by the policies of the Institute and authorize the use of my likeness, appearance, performance, voice, name, and student projects in connection with the operation and promotion of the Institute. I acknowledge that the Institute has the right to withdraw an application with notice at any time before classes start. I also understand that F.I.R.S.T. Institute reserves the right to withdraw subjects, courses, and programs if registration falls below the required number, and to change the faculty and staff without prior notice to students. I hereby grant F.I.R.S.T. Institute permission to make any necessary inquiries. I voluntarily and knowingly authorize any former school, government agency, employer, person, firm, corporation, its officers, employees and agents to comply with such request. The information I have provided is complete and accurate to the best of my knowledge. *Please note that a $35.00 application fee is required to process your application. You will be able to pay this on the next page after you hit "Submit" *Please note that a $35.00 application fee is required to process your application. APPLICATION FEE : $35.00NameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.