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GET A WPETC ID

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  2. An ETC ID is required in order to participate in any activities at the WPETC. Kindly complete all sections on this form and an ID will be printed for you upon your first visit to the ETC. Thank you!

  3. CONTACT INFORMATION:

  4. HOW DID YOU HEAR ABOUT THE WHITE PLAINS EDUCATION & TRAINING CENTER?*

  5. TELL US ABOUT YOURSELF:

  6. Please answer the following regarding your GROSS HOUSEHOLD YEARLY INCOME:

    (Gross Household Annual Income is the amount prior to withholding taxes for everyone in your home.)

  7. PERSONAL DATA:

  8. PLEASE CHECK ALL BOXES THAT APPLY:*

  9. RACE: *

    Please check all boxes that best apply

  10. In addition to the race selection you entered, please indicate if you are ALSO Hispanic.

  11. You are currently:*

  12. Please check the choice that best describes your level of education:*

  13. How did you hear about the WPETC?*

  14. I hereby certify that, to the best of my knowledge, the above statements are true and correct. I understand this information is subject to verification only by personnel authorized HUD (U.S. Department of Housing & Urban Development)

  15. Leave This Blank:

  16. This field is not part of the form submission.