BASIC HEAVY EQUIPMENT OPERATION 3 WEEK TRAINING PROGRAM
Application for Admission 2012

Directions: Please either complete this application and submit it on-line; or print it, fill it in, and mail or fax to us:

Laurie Bergquist, Admissions Director
North Country Heavy Equipment School, LLC
2929 16th Avenue North
Escanaba, MI 49829		 Phone: 906-789-3123
Fax: 906-789-3124
Email:
info@RunMonsterMachines.com
Name (required):
Address:
City, State/Prov., Zipcode:
Area Code & Phone Number:
Email Address (required only if submitting on-line):
Sponsoring Agency (if applicable):
Address:
City, State/Prov., Zipcode:
Counselor:
Area Code & Phone Number:

Course starting dates for 2012 are listed below. Number your 1st and 2nd choice, by writing a 1 or 2 in the space. Enrollment is limited to 12 people for each class.

April 2 - April 20 June 25 - July 13 Aug. 27 - Sept. 14
April 23 - May 11 July 16 - Aug. 3 Sept. 17 - Oct. 5
May 14 - June 1 Aug. 6 - Aug. 24 Oct. 8 - Oct 26
June 4 - June 22        

Would you like someone to contact you with more information? Yes No Not Sure

How did you learn about the Heavy Equipment Course? (check all that apply)

Counselor Friend Someone who took the course
TV Radio Flyer
Newspaper Employment Office Website / Search Engine
Other
Please call if you have any questions, 906-789-3123.
Thank You For Your Application!

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