2024 ESE Application

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First, Middle Initial, Last
I want to take the course on:
I want to take the following course:

Student Data Collection

Kitsap County is a Private Career School that is licensed and regulated by the Washington State Workforce Board.

The Workforce Board requires that we ask you for this information, by law (RCW 28C.10.050). Providing your social security number is voluntary. By law, the information you provide on this form cannot be given out by any state agency as public information. The Workforce Board will not disclose data to anyone except authorized Workforce Board employees or contractors working on specific research activities, who follow strict confidentiality procedures. This format follows the information required to be submitted by the school as part of the annual student data report.

Race, Gender, and Veteran portion of the application is not mandatory to fill out to be accepted, however is appreciated.

Highest Grade Completed

Contract Information and Agreement

Is an Fire or EMS Agency sponsoring your tution for this class?


The fee for the class is non-refundable after the deadline, whether or not the student attends the class.


Cancellation/Withdrawal Policy: Please check the boxes below agreeing to the policy.