Apply Online

Apply Online 

Please fill out the following application form and one of our admissions representatives will contact you within 48 hours. Thank you for your time.

* indicates required fields

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Campus Location of Interest: *
Program of Interest: *
 

GENERAL INFORMATION

Last Name *
First Name *
Middle Initial
Maiden Name (If applicable)
   
Street Address *
City *
State *
Country (If other than U.S.)
Zip Code *
 
Email Address *
Home Phone *
   
Work Phone
   
Where can we contact you now?
Home  Work
Are you active duty, a veteran or a military dependant?
What prompted you to visit today?

PERSONAL

Date of Birth
/ /
MM/DD/YYYY
Driver's License Number
   
Gender:
  Male      Female
 

EDUCATION

I have graduated from
high school:
Yes No
I am planning to graduate
from high school:
Yes No
I have received a GED certificate:
Yes No
I am expecting to receive a GED certificate:
Yes No
If Yes, Month/Year
/
MM/YYYY
If Yes, Month/Year
/
MM/YYYY
If Yes, Month/Year
/
MM/YYYY
If Yes, Month/Year
/
MM/YYYY
Name of high school
City
State
Name as it appears on high school academic records:
Have you applied to THIS institution before?
Yes No
If yes, for which year?

(YYYY)

Have you attended college before?
Yes No

If you have attended college, approximately how long did you attend?
Less than 1 year
1-2 years
2-3 years
3-4 years

Degree received?
Yes No

Extracurricular Activities (such as community or school involvement):

EMPLOYMENT

Current Employer:
Position:
Duties:
Indicate the number of hours you currently work per week:
Have you set money aside for your education?
Yes No

METHOD OF PAYMENT

I will require financial assistance
I won’t require financial assistance.
Are you a U.S. citizen? Yes No
What are you hoping to achieve with your education from Pinnacle Career Institute?
How quickly are you looking to start your career?

Clicking the "Apply Online" button below constitutes your express written consent to be called and/or texted by PCI at the number(s) you provided, regarding furthering your education. You understand that these calls may be generated using an automated technology.