I’M INTERESTED IN THE PAID TUITION & REWARD PROGRAM

By filling out and submitting this form, you are taking a significant stride towards shaping a brighter future for yourself through our paid tuition and reward program. Complete the application and submit the $25 non-refundable Application Administrative fee and a representative from DG Foundation will promptly contact for follow-up. 

Must be a Valid Mailing address. No PO Boxes.
Mobile #? *

Alternate Contact Information

Provide Full name of an Alternate contact in case we cannot get a hold of you.

General Employment Information

Employment Type:
Choose All that Apply
Unemployment Benefits:
Date you started with your employer
How long have/were you with your Employer
Note: Your Military Status does not affect the application process.

Employment Goals

Enter at least one and up to three employers you would like to work for and teh poisitions you would like.

funding information

Please indicate how you intend to pay for your training (tuition, fees, books, tools, supplies, room and board). It is highly recommended that you apply for grants and scholarships to help fund your training. Please indicate which forms of funding you intend to apply for:

Personal Funds: *
Scholarships *
State / Federal Loans: *
State of Nevada Grant: *
Employer Funded: *

Educational Background

High School Graduate?: *
GED Graduate?:
Have you attended any Post Secondary Academic Institutions or Vocational Schools: :

Statement of Correctness, Understanding, Authorization and Privacy Act Waiver

I understand that I must submit a $25 non-refundable application fee for all programs Longer than 80 Hours with this application.

I understand that my program may require a drug screen and physical exam. I understand that these are mandatory to participate in that program.

I understand and consent that if enrolled; I will be placed in a random drug testing database and could be called at any time for a retest. I understand that if I fail a drug test, at any time, I will be released from training.

I understand that there are physical demands of working in these skilled trades, no matter wherever located geographically. I have or will obtain suitable work gear to be able to perform my work required to complete this trade school training opportunity.

I understand that I may be required to lift up to 50 pounds. Training may require constant bending, twisting, stooping, lifting, climbing of stairs or hills, and sitting or standing for extended periods of time, in all types of weather.

I agree and understand that if I quit or get expelled from the qualified trade school training awarded by the Diesel Garage Foundation, I am responsible and accept the responsibility to pay back the full financial amount of the scholarship awarded to me.

I hereby attest that all the information I have provided to the Diesel Garage Foundation is true, correct, and complete.