Project Management Certificate Program Application for Admission Last Name: First Name: Address: Email Address: Cell Phone: CSID: Highest Level of Education: GED/HS Associate Bachelors Masters Higher List degrees, certificates, or classes you have taken that you think are relevant to the PM Certificate Program: Mon/Wed Thurs/Saturday Friday Can you find access to a PC to download free 60-day trial of MS Project 2013? Currently employed? Yes Yes No No If yes, Employer and Position: _____________________________________________________________ SELF ASSESSMENT regarding your Project Management experience (circle): Your work experience: Project member: A lot (more than a year) A Little None Project manager: A lot (more than a year) A Little None If other than None to the above: a. What industry or industries (e.g., construction, retail)? _______________________________________________________________________ b. What was the biggest problem and/or challenge? _______________________________________________________________________ In a typed essay format (single page), please provide the following information on the next page: What are your reasons for wanting to participate in this program? Your personal learning objectives from this program; i.e., what do you want to take away from the program? Goals upon completion of this program; i.e., what do you hope to do with the program certificate and the program learning? If appropriate, your experience with projects and project management. For this response, the project must be greater than three (3) months in duration and have greater than two (2) people on the project team. ENTRANCE ESSAY/PROJECT MANAGEMENT CERTIFICATE PROGRAM Name: Date: Email Address: CSID: Requested Information: