Phone Number *

Secondary Phone Number

Email*

Please make sure email address is accurate, you will receive a confirmation email from EITI sent within 48 hours.

Street Address*

City*

State*

Zip Code*

Courses*
Pre-Apprentice CarpentryPre-Apprentice ElectricalAdvanced Call CenterRenewable EnergyCDL-AHospitalityCulinary Arts

Documentation Required (check if you have) *
Valid Michigan State IDValid Michigan Driver’s LicenseSocial Security Card

Do you have any of these? ( Not required for approval )
High School DiplomaGED

Do you have a criminal background? *
FelonyMisdemeanorN/A

Are you currently working?*
Yes - MorningsYes - AfternoonsYes - MidnightsNo

Have you attended a MI Works orientation in the last 90 days? *
YesNo
If so, what is your career advisors name and email address?

If so, have you taken the CASAS or TABE test?
YesNo
If so, what are your Math and English scores?

If yes, which MIWORKS location?
---Detroit – Samaritan Center – 5555 Conner Detroit, MI 48213Detroit – Northwest Activity Center 18100 Meyers Detroit, MI 48235Detroit – SerMetro 9301 Michigan Ave. Detroit, MI 48210Highland ParkWayne/WestlandYpsilanti/Washtenaw CountyOther: Please Note Location
MI WORKS location if not listed:

Do you participate in any of these programs?
Michigan Rehabilitation Services (Do you have an active case?)

Have you been approved and have you completed Michigan Works training in the last 3 years? *
YesNo

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