Home / School ApplicationPerfect Technician AcademySchool ApplicationApplicant InfoName* First Name Middle Name Last Name Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email* Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Course/Seminar of Interest*Select a course/seminarCourse: HVAC Repair Service TechnicianQuestionnaireDo you have a valid SSN or other 9-digit identification number?*We don’t need it right now, but will for enrollment documents at our facility.YesNoDo you have a valid driver’s license?*YesNoDo you have a high school diploma or GED?*YesNoHave you ever been convicted of, pled no contest to, been placed on probation for a felony or misdemeanor (other than a traffic violation), or are you currently on probation or parole?*YesNoPlease list them all*Did you serve in the military?*YesNoVeteransBranchUS Marine CorpsUS ArmyUS NavyUS Air ForcesCoast GuardRankMOSMo/Year of SeparationYears ServedPlease enter a number from 1 to 100.Employment History From Most RecentCompany*City / State*How Long*Job Title*Pay Rate*Additional Jobs Add JobCompany*City / State*How Long*Job Title*Pay Rate*Additional Jobs Add JobCompany*City / State*How Long*Job Title*Pay Rate*Education HistorySchool Name*City / State*Graduated*YesNoCourse Description*Additional School Add SchoolSchool Name*City / State*Graduated*YesNoCourse Description*Additional School Add SchoolSchool Name*City / State*Graduated*YesNoCourse Description*Certifications and AccomplishmentsDescription / Year AwardedIndustry & Medical InformationAre tight / cramped spaces a challenge for you?*YesNoHeating and Air Conditioning technicians and installers work in very hot and cold environments from time to time. Do you have any health conditions that will prohibit you from working in these type of environments?*YesNoExplain*Do you have any concerns or medical conditions that will restrict lifting weight of 70 lbs?*YesNoIs there any medication that you take on a regular basis that would prevent you from driving, lifting, being in hot areas for extended periods of time, or being around mildew or biological growth common to damp and musty areas?*YesNoExplain*Do you take any medications that would prevent you from working alone, operating equipment, or any other action that is common to the trades and construction industry?*YesNoList any medical conditions that the school needs to be aware o*How did you hear about the academy?*Consent* I agree to the Perfect Technician Academy Privacy Policy.*Δ