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IT Apprenticeship Application

APPLICATION FOR APPRENTICESHIP TRAINING

In order to be eligible for the AT&T Catapult Apprenticeship Program, you must meet the following general and academic requirements:

General Requirements

• Be a U.S. Citizen
• Be capable of achieving and maintaining a federal security clearance.
• Be able to lift and move weights of up to 50lbs.
• Have a valid drivers license

Academic Requirements

• Have completed less than 50% of the curriculum listed for at least one of the apprenticeship tracks
• Be in good academic standing with HCC
• Have demonstrated course completion and enrollment in at least one Science, Technology, Engineering, or Mathematics (STEM) course
• Hold an active certification from a relevant workforce training program or industry examination

SECTION ONE - GENERAL INFORMATION

S1-1. DEMOGRAPHIC

First Name:*

Last Name:*

Middle Initial:

Will you be 18 or older by 02/1/2022?*

Yes No

Providing the below demographic information is voluntary and does not effect your program application. Any information reported is confidential and will only be used to report accurate aggregate demographic data.

Gender

Male Female

Are you of Hispanic or Latino origin?

Hispanic/Latino

Non-Hispanic/Latino

What is your race? Select one or more.

Asian

Black/African American

Native American/Alaska Native

Native Hawaiian/Other Pacific Islander

White

Other

Are you a Veteran?

Yes No

Are you a current or previous HCC Student?

Yes No

S1-2. CONTACT INFORMATION

Street Address:

Address 2nd Line

Apt/Unit

City:

State:*

Zip Code:

Primary Phone:*

Phone Type:

Secondary Phone:

Phone Type:

Email Address:*

SECTION TWO - ACADEMIC HISTORY

S2-1. STUDENT CONDUCT

Are you currently, or have you ever been, involved in a disciplinary process at another school or institution?*

Yes No

Are you currently in good academic standing with HCC or your current school or institution?*

Yes No

S2-2. HIGH SCHOOL EDUCATION

Prior to program start (DATE), will you have a high school diploma or GED?:*

Yes No

If YES, Please Select One (HCC School lists or out of state/out of county/GED)*

If not listed above, please specify the high school you attended below. Include the schools full name, city, state, and zip; country for international high schools.

S2-3. POSTSECONDARY EDUCATION

Please indicate the highest level of postsecondary education you have attained:*

Completed some college

Associate's Degree

Bachelor's Degree

Master's Degree

Doctoral Degree

Professional or Technical Certifications

Please provide the information below for up to the last three post-secondary institutions you have attended.

First College/Institution Attended

Name of School/Institution

City & State or County

Field of Study

Years Attended (YYYY - YYYY)

Second School/Institution Attended

Name of School/Institution

City & State or County

Field of Study

Years Attended (YYYY - YYYY)

Third School/Institution Attended

Name of School/Institution

City & State or County

Field of Study

Years Attended (YYYY - YYYY)

SECTION THREE - SPECIFIC COURSE COMPLETION AND ENROLLMENTS

If you are a current or previous HCC student, please indicate completion or enrollment in the following courses. If you have not taken coursework at HCC prior to this, please select N/A for the following responses.

S3-1. COMPUTER SYSTEMS COURSES

CMSY-105 Maintenance of PC and Mobile Devices I*

Completed Enrolled N/A

CMSY-106 Maintenance of PC and Mobile Devices II*

Completed Enrolled N/A

CMSY-156 Introduction to Python*

Completed Enrolled N/A

CMSY-158 Fundamentals and Practice for N+ Certification*

Completed Enrolled N/A

CMSY-163 Introduction to Firewalls and Network Security*

Completed Enrolled N/A

CMSY-164 Introduction to ID/PS*

Completed Enrolled N/A

CMSY-176 Cybersecurity Fundamentals and Practice*

Completed Enrolled N/A

CMSY-219 Operating Systems*

Completed Enrolled N/A

CMSY-255 Introduction to Unix and Linux*

Completed Enrolled N/A

CMSY-256 Linux Server Administration*

Completed Enrolled N/A

CMSY-262 Secure Communication and Encryption*

Completed Enrolled N/A

S3-2. CISCO COURSES

CSCO-291 Introduction to Networks*

Completed Enrolled N/A

CSCO-292 Switching, Routing, and Wireless Essentials*

Completed Enrolled N/A

CSCO-293 Enterprise Networking, Security, and Automation*

Completed Enrolled N/A

CSCO-305 Cisco IP Telephony*

Completed Enrolled N/A

CSCO-651 CCNP Enterprise: Core Networking*

Completed Enrolled N/A

S3-3. ELECTRICAL COURSES

ELEC-141 Network Configuration and Cabling*

Completed Enrolled N/A

SECTION FOUR - WORKFORCE TRAINING AND CERTIFICATIONS

S4-1. CompTIA Certifications

Please indicate whether you have completed any of the following CompTIA Certifications:

CompTIA A+*

Yes No

Date Certificate Earned: (MM/YYYY)

CompTIA Network+*

Yes No

Date Certificate Earned: (MM/YYYY)

CompTIA Security+*

Yes No

Date Certificate Earned: (MM/YYYY)

S4-2. OTHER TRAINING OR CERTIFICATES

Have you completed any other workforce training or certification programs?*

Yes No

IF YES, Please provide the information below for any training or certificate programs you have completed, otherwise continue to SECTION FIVE.

First Training/Certificate Completed

Program Provider

Name of Training/Certificate

Date Earned (MM - YYYY)

Second Training/Certificate Completed

Program Provider

Name of Training/Certificate

Date Earned (MM - YYYY)

Third Training/Certificate Completed

Program Provider

Name of Training/Certificate

Date Earned (MM - YYYY)

SECTION FIVE - SECURITY PRE-SCREENING

S5-1. SIGNATURE STATEMENT

AT&T conducts a pre-screening as the first step in the background investigation of persons under consideration for the security clearance Process. Information obtained and discussed during this prescreen is part of your permanent record in the federal security clearance process and will be used as a basis for future steps in the process.

Your responses to pre-screen questions will be compared with those provided in future employment and security clearance forms so it is imperative that you provide true and accurate information during the prescreen. Withholding, misrepresenting, or falsifying information will have an impact on the federal security clearance process, employment prospects, job status, and ongoing eligibility for the AT&T Catapult Program.

I certify that I have read the following statement pertaining to the AT&T Catapult Program’s pre-screen process:

Please type your full name*

S5-2. SECURITY QUESTIONS

Q1. Are you a U.S. Citizen?*

Yes No

Q2. Do you currently hold a dual citizenship with another country?*

Yes No

Q3. Have you used any illegal substances or controlled substances that were not prescribed in your name?*

Yes No

Q4. Do you have a criminal record?*

Yes No

Q5. Do you have any family members or friend(s) that are foreign nationals and/or live outside of the United States?*

Yes No

Q6. Have you traveled outside of the United States to visit another country?*

Yes No

SECTION SIX - APPLICATION DOCUMENTS

THE FOLLOWING MUST BE UPLOADED WITH THIS APPLICATION. This information MAY NOT be submitted via email.

A scanned copy of your high school diploma, GED certificate, or unofficial transcript of last grade complete.*

A copy of your current resume in PDF format.*

AT THIS TIME, THE FOLLOWING CAN BE UPLOADED WITH THIS APPLICATION OR SUBMITTED BY EMAIL.
Recommendation letters submitted by email must be SIGNED copies that have been scanned or photographed. Text documents will not be accepted. Recommendations may also be submitted BY THE ACQUAINTANCE that has written your recommendation to apprentice@howardcc.edu.

Scanned copies of written recommendation letters from three (3) acquaintances.

If you have any questions regarding your document submissions, please email them to apprentice@howardcc.edu.

If you are human leave this blank.

Do not fill in this field:

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IT Apprenticeship Application