MILESTONE INSTITUTE OF NEW JERSEY
APPLICATION FOR ADMISSION

(PLEASE PRINT ALL INFORMATION CLEARLY)

  • Programs interested:
  • ESL    Computer Office Professional    Massage Therapy    Medical Administrative Office Assistant   
  • Personal Trainer   
  • Name:
  • Home Address:
  • Foreign Address:
  • Gender:
  • male    female
  • Proposed Program Start Date:
  • Ethnic Background:
  • White/non-Hispanic    Hispanic    Asian or Pacific Islander    African American/non-Hispanic   
  • 2 or more ethnic background    American Indian or Alaskan Native   
  • Nationality :    Country of Citizenship :
  • Education:
  • Are you a high school graduate or soon will be?   Yes    No   
  • If “yes” list high school below:
  • Non-High School Graduate/Has GED    Yes
  • List all colleges, universities or other institution of higher education previously attended:
  • Name of School / Address Year Completed Graduated Degree Earned
  • Emergency Contact :
  • The above information is true and accurate. Furthermore, I understand my completion of and signature on this Application for Admission does not mean I am enrolled and accepted into Milestone Institute of New Jersey.

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