Are you already a Gilbert Together student? Ready to register for next semester? No need to apply again. Instead, complete this online form for previous students. Personal Information * indicates required field Full Name * Mailing Address * Cell Phone * Home Phone Email Address * Gender Are you a legal resident of the United States of America? Yes No Have you been a resident of the State of Arizona for 12 months or more? Yes No Do you have a State of Arizona issued driver's license or ID card? Yes No Are you a resident of the Town of Gilbert? Yes No Please indicate your current age: 18-19 20-24 25-29 30-39 40-49 50 or older Have you been directly impacted by COVID-19? (please choose all that apply) Temporary Loss of Employment Provided Care for Someone Infected With COVID-19 Hours of Employment Reduced I am a business owner forced to close my business due to COVID-19 Substantial Financial Loss Assist with Support of Family Member(s) Affected by COVID-19 Permanent Loss of Employment Provide Full-Time Care For Children Now In Homebound Schooling Living Circumstances Furloughed Other If you have been impacted by COVID-19, please describe the impact: * - Required Are you a Veteran? Yes No Ethnicity * - Required SelectAmerican Indian or Alaska NativeAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or Pacific IslanderWhite/CaucasianOther What is the highest level of education you have completed? * - Required SelectGEDHigh School Graduate1-3 Years of College2-Year College Graduate4-Year College GraduateSome Graduate SchoolGraduate School Graduate Please list any college courses, certificates, or degrees: What is/was your salary range before you were affected by COVID? (your response to this question does not disqualify you) * - Required SelectBelow $20,000$21,000-$40,000$41,000 and above Have you ever attended a Maricopa County Community College? Yes No If yes, what is your MEID number? If yes, what campus(es) did you attend? Chandler-Gilbert Estrella Mountain GateWay Glendale Mesa Paradise Valley Phoenix College Rio Salado Scottsdale South Mountain When would you like to start taking classes? June 2021 August 2021 October 2021 December 2021 Are you already receiving financial aid? Please specify: Certificate of Completion – Area of Interest (Select 1) When you apply to college, you will need to choose your major. Your major indicates the program that you plan to complete and provides a pathway map for enrolling in courses. The #GilbertTogether program only funds courses that are part of an approved Certificate of Completion (CCL). If you are interested in pursuing multiple program areas or continuing on to an Associate of Applied Science (AAS) degree, our enrollment services staff can assist you with your education plan. The #GilbertTogether program allows for funding to enroll in courses associated with multiple majors on this list, but you can only select one major which identifies your primary program of study. Please select your desired college to see the list of available Certificates of Completion (CCL) for this program at that college. Which campus are you interested in taking the courses at? MCC CGCC Business Programs Accounting, Banking, and Finance Accounting Enrolled Agent Business Administrative Professional Business Administration Fastrack General Business Business and Organizational Management Human Resources Management Management Organizational Leadership Retail Management Small Business Management Level I Small Business Management Level II Small Business Start-Up Entrepreneurial Studies Entrepreneurial Studies Level I Entrepreneurial Studies Level II Fashion Design and Merchandising Alteration Specialist Apparel Construction Costume Design and Production, Level I Fashion Design: Level I Image Consultant Retail Sales Manager Textile and Apparel: Fashion Stylist Insurance Insurance Marketing Marketing Social Media Marketing Project Management Project Management Real Estate Real Estate: Prelicense Health Care Programs Emergency Medical Technology Emergency Medical Technology Emergency Medical Technology Comprehensive Nurse Assisting Nurse Assisting Paramedicine Community Health Paramedicine Critical Care Paramedicine Paramedicine Tactical Emergency Casualty Care Information Technology Artificial Intelligence Artificial Intelligence and Machine Learning Computer Information Systems Amazon Web Services Practitioner Cloud Computing Data Analytics Database Development Microsoft Office Professional Microsoft Office Specialist Oracle Database Operations Desktop Support Computer System Configuration and Support Computer System Configuration and Support, Linux Computer System Configuration and Support, Network Computer System Configuration and Support, Security Desktop Support Digital Arts Graphic Design Illustration Networking and Security Cisco Certified Network Professional: Enterprise Advanced Routing and Services Cisco Certified Network Professional: Enterprise Core Cisco Network Administration and Security Cisco Network Administration: CCNA Cisco Network Administration: CCNP Cyber Engineering Cybersecurity Engineering Cybersecurity Fundamentals Cybersecurity Operations Linux Associate Linux System Administration Microsoft Desktop Associate Red Hat Linux Administrator Red Hat Linux Engineer VMware Foundations VMware Systems Administrator Programming and Mobile App Development Android App Development Cross-Platform App Development Foundations of Mobile App Development iOS Application Development Mobile App Development Native Mobile App Development Programming and Systems Analysis Level I Programming and Systems Analysis Level II Windows App Development Web Design and Development Adobe Foundations: Animation and Graphics Production Adobe Foundations: Audio and Video Production Web App Development Web Design Web Development Web Foundations Manufacturing Programs Aircraft Maintenance Technology Aircraft Maintenance Technology Aircraft Maintenance Technology - Airframe Aircraft Maintenance Technology - Powerplant Automated Industrial Technology Automated Industrial Technology I Automated Industrial Technology II Industrial Robotics and Automation Technology Computer Assisted Design and Drafting Computer Aided Drafting Mechanical Drafting Electronics Technology Electronics Technology Manufacturing CNC Machine Operator CNC Machining I CNC Machining II Welding Welding Welding: Fundamentals Welding: Gas Metal / Flux Cored Arc Welding Welding: Gas Tungsten Arc Welding Ferrous Welding: Gas Tungsten Arc Welding Non-Ferrous Welding: Shielded Metal Arc Welding Pipe Welding: Shielded Metal Arc Welding Plate Trade Programs Automotive Service Automotive Automatic Transmission and Transaxle Automotive Brake Systems Automotive Chassis Automotive Drive Chain Automotive Electrical, Heating, Ventilation and Air Conditioning Systems Automotive Electronic/Electrical Systems Automotive Engine Performance Automotive Engine Repair Automotive Engine Repair and Performance Automotive Heating, Ventilation and Air Conditioning Systems Automotive Maintenance and Light Repair Automotive Manual Drive Train and Axles Automotive Service Automotive Steering and Suspension Aviation Unmanned Aircraft Systems Construction Trades Building Inspection Construction Building Codes Construction Safety OSHA 30 Construction Trades: Construction Management International Residential Code Other CCL Additional Information Upon completion of this CCL, I would be interested in working within city limits of the Town of Gilbert, AZ: Yes No Comments Understanding & Acknowledgement By clicking submit at the end of this form, I understand and agree to all of the following terms: I understand that I am a resident of the Town of Gilbert in Maricopa County in the State of Arizona and that I have been adversely affected by COVID-19. I understand that participation in CCL training may include career assistance services and that I may be contacted by phone, text and/or email regarding additional educational and career assistance opportunities up to one year after completion of my course of study. I understand that the information I have provided in this questionnaire is correct to the best of my knowledge and I understand that to falsify information is grounds for refusal of services. Please type your First and Last Name in the box provided.