NATIONAL BROADCASTERS TRAINING NETWORK
ENROLLMENT APPLICATION

Thank you for applying for enrollment with National Broadcasters Training Network.

Broadcasting School Enrollment Success If accepted for enrollment, NBTN will be placing you into a mentor-apprentice relationship with a selected professional broadcaster at a radio/TV station in your area.

NBTN student-apprentices spend significant time at their radio or television station and generally interact with other members of the station's staff as well. Therefore, please keep in mind that this station is your mentor's actual workplace, they are "vouching" for your presence there. As such, our mentor/instructors rely on the NBTN admissions staff to pre-screen potential applicants prior to being accepted for enrollment. All information submitted via this Enrollment Application is used for these purposes only. All information is held confidential and no personal information is made available to any third party at any time.

National Broadcasters Training Network admissions decisions are made without regard for age, race, color, creed, sex, religion, disability, sexual orientation, national or ethnic origin.

Fields marked with * are required.





NATIONAL BROADCASTERS TRAINING NETWORK ADMISSION DEPARTMENT



Disclaimer:	All of the information that you provide is kept completely secure and confidential and will not be used for anything other than processing your potential loan application.



PERSONAL CONTACT INFORMATION



Your Personal Information	* First Name:
	* Last Name:
	Middle Name:
	Jr./Sr.	Junior Senior
	Preferred Name:
	Gender:	Male Female
	Date of Birth:



Permanent Address	Street Address:
	Apartment:
	City:
	State:
	Zipcode:
	Time at Address?:	Years Months
	Home Status:	Own Rent Live at Home

If You Have Not Lived At The Above Address For Three Years,	Please indicate your prior residency(s) for within the last three years.			Prior Address-1

				Prior Address-2



Mailing Address (If Different than above please fill out):	Same As Above?:	Check here if same as permanent address

	Street Address:
	Apartment:
	City:
	State:
	Zip Code:



Contact Information	Home Phone:
	Cell:
	Fax:
	* Email:



EMERGENCY CONTACT INFORMATION



Their Name	First Name:
Their Name	Last Name:



Permanent Address (if different)	Street:
	Apartment:
	City:
	State:
	Zipcode:
	Country:



Contact Information	Home Phone:
Contact Information	Email:


EDUCATIONAL HISTORY



High School	High School:
	Year Graduated:
	City:
	State:



If you did not graduate from high school, have you passed a General Education Development test (GED)? (Mandatory for enrollment)		Yes No



Vocational School	Vocational School:
	City:
	State:
	Attendance Dates:
	Area of study:
	Degree/Diploma:



College	College Name:
	City:
	State:
	Attendance Dates:
	Major:
	Degree/Diploma:



FINANCIAL INFORMATION



If accepted, do you plan to apply for a student loan?		Yes No
If you indicated that you plan on using a student loan, the following information is required for processing..



CURRENT EMPLOYMENT



Where Do You Work	Company Name:
	Your Position/Title:
	Length At Job:	Years Months
	Monthly Income:		Approximate
	City:
	State/Province:
	Phone:



OTHER FINANCIAL INFORMATION



If Applicable	Other Income:
If Applicable		Note: You do not need to reveal alimony, child support, or maintenance income unless you wish it to be considered as a basis for your loan repayment



Expense Information	Living Expense:
Expense Information		Monthly Rent/Mortgage Amount



Loan Identification	Drivers License / State Issued I.D.:
	Social Security :
	Are you a U.S. Citizen and/or a Permanent Resident Alien?	Yes No
	If no:	Please indicate citizenship
	Do you have a checking/savings account?	What bank do you use?



PERSONAL REFERENCES



Personal Reference 1	Relationship to Borrower:
	Current Address:
	Apartment:
	City:
	State:
	Zip Code:
	Phone:



Personal Reference 2	Relationship to Borrower:
	Current Address:
	Apartment:
	City:
	State:
	Zip Code:
	Phone:



Personal Reference 3	Relationship to Borrower:
	Current Address:
	Apartment:
	City:
	State:
	Zip Code:
	Phone:



CO-SIGNER INFORMATION



Co-Signer Personal Information	Relationship to Borrower:
	First Name:
	Last name:
	Middle:
	Jr./Sr.:	Junior Senior
	Preferred Name:
	Gender:	Male Female
	Date of Birth:



Co-Signer Permanent Address	Current Address:
	Apartment:
	City:
	State:
	Zip Code:



Co-Signer Mailing Address (If Different than above please fill out):	Same As Above?:	Check here if same as permanent address

	Street Address:
	Apartment:
	City:
	State:
	Zip Code:



Co-Signer Contact Information	Home Phone:
	Cell:
	Fax:
	Email:



CO-SIGNER EMPLOYMENT



Co-Signer, Where Do You Work	Company Name:
	Your Position/Title:
	Length At Job:	Years Months
	Monthly Income:		Approximate
	City:
	State/Province:
	Phone:



CO-SIGNER FINANCIAL INFORMATION



Co-Signer If Applicable	Other Income:
Co-Signer If Applicable		Note: You do not need to reveal alimony, child support, or maintenance income unless you wish it to be considered as a basis for your loan repayment



Co-Signer Expense Information	Living Expense:
Co-Signer Expense Information		Monthly Rent/Mortgage Amount



Co-Signer Loan Identification	Drivers License / State Issued I.D.:
	Social Security :
	Are you a U.S. Citizen and/or a Permanent Resident Alien?	Yes No
	If no:	Please indicate citizenship
	Do you have a checking/savings account?	What bank do you use?



CO-SIGNER PERSONAL REFERENCES



Co-Signer Personal Reference 1	Relationship to Borrower:
	Current Address:
	Apartment:
	City:
	State:
	Zip Code:
	Phone:



Co-Signer Personal Reference 2	Relationship to Borrower:
	Current Address:
	Apartment:
	City:
	State:
	Zip Code:
	Phone:



Co-Signer Personal Reference 3	Relationship to Borrower:
	Current Address:
	Apartment:
	City:
	State:
	Zip Code:
	Phone:



NATIONAL BROADCASTERS TRAINING NETWORK PLACEMENT DEPARTMENT



If accepted, when would you prefer to begin your training?



Start Date		As Soon As Possible
		Within 30/60 Days
		After 60 Days Or More



YOUR STATION PREFERENCES



Please provide a list of stations you would prefer to train with. For help researching station options and information in your area, click here to visit www.radio-locator.com Please list a minimum of five stations - in order of preference - as follows: Example: 1. WXYX-FM 106.5, Detroit, MI.



Favorite Stations you want to train at:	Station #1:
	Station #2:
	Station #3:
	Station #4:
	Station #5:
	Station #6:
	Station #7:
	Station #8:



TELL US MORE ABOUT YOU



Career Goals	1. Do you have any paid, unpaid, or volunteer experience in broadcasting? If so, please explain:
	2. Why are you interested in becoming a professional broadcaster?
	3. Why do you feel National Broadcasters Training Network is a good fit for you?
	4. In considering your application, is there anything else you would like us to know about you?







Questions regarding this Enrollment Application? Call 1-888-76RADIO or 425-673-4505 After reviewing your Enrollment Application we'll evaluate it to ensure eligibility and compatibility with the goals of our program. If both parties are comfortable moving forward, we'll review your station preference list and discuss your potential mentor/station placement options, tuition arrangements, and start date. Privacy policy - This application will be submitted to National Broadcasters Training Network for enrollment consideration purposes. All information submitted is held confidential and is used only for the expressed purposes for which it is intended. No personal information is made available to any third party at any time.

NATIONAL BROADCASTERS TRAINING NETWORK ENROLLMENT APPLICATION

NATIONAL BROADCASTERS TRAINING NETWORK ADMISSION DEPARTMENT

PERSONAL CONTACT INFORMATION

EMERGENCY CONTACT INFORMATION

EDUCATIONAL HISTORY

FINANCIAL INFORMATION

CURRENT EMPLOYMENT

OTHER FINANCIAL INFORMATION

PERSONAL REFERENCES

CO-SIGNER INFORMATION

CO-SIGNER EMPLOYMENT

CO-SIGNER FINANCIAL INFORMATION

CO-SIGNER PERSONAL REFERENCES

NATIONAL BROADCASTERS TRAINING NETWORK PLACEMENT DEPARTMENT

YOUR STATION PREFERENCES

TELL US MORE ABOUT YOU

NATIONAL BROADCASTERS TRAINING NETWORK
ENROLLMENT APPLICATION

NATIONAL BROADCASTERS TRAINING NETWORK
ADMISSION DEPARTMENT

NATIONAL BROADCASTERS TRAINING NETWORK
PLACEMENT DEPARTMENT