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: