Interest Form Thanks for your interest in WorkforceLinc! Please fill out the form below and a member of our team will be in touch. Name(Required) First Last Phone number(Required)Email address(Required) What program are you enrolled in?(Required)If you are not currently enrolled, what program are you interested in?SelectAutoDieselElectricalHVACAre you enrolled at Lincoln Tech?(Required) Yes No Other Current Institution (Optional)Lincoln Tech Campus(Required)If you are not currently enrolled at Lincoln Tech, what campus are you interested in?SelectAllentownColumbiaDenverEast PointEast WindsorGrand PrairieHoustonIndianapolisLevittownLincoln Mall – Rhode IslandMahwahMariettaMelrose ParkMoorestownNashvilleNew BritainParamusPhiladelphiaSheltonSouth PlainfieldQueensUnionLincoln Tech emailIf you do not have a Lincoln Tech email, provide your personal email addressOther(Required)Your anticipated graduation dateMonthMonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDayDay12345678910111213141516171819202122232425262728293031YearYear20272026202520242023202220212020Please select the program you are most interested in(Required) Food Industry Technician HussmannTECHX Johnson Controls Peterbilt Republic Services Tesla Other Please select the program you are most interested in(Required) Food Industry Technician HussmannTECHX Johnson Controls Peterbilt Republic Services Tesla Please select the program you are most interested in(Required)Select First ChoiceSelectFood Industry TechnicianHussmannTECHXJohnson ControlsPeterbiltRepublic ServicesTeslaOtherSelect Second Choice(Required)Select Second ChoiceSelectFood Industry TechnicianHussmannTECHXJohnson ControlsPeterbiltRepublic ServicesTeslaOtherSelect Third ChoiceSelect Third ChoiceSelectFood Industry TechnicianHussmannTECHXJohnson ControlsPeterbiltRepublic ServicesTeslaOtherHow did you hear about the program?(Required)Presentation at your campusCareer ServicesSocial MediaFlyerWFL WebsiteWhich Account Manager discussed this program with you?(Required)SelectCorinne BenvenutoMonica DaughtryDelexica DurhamKeston EdwardsBryan FeilenAlexandra FritzJose GallegosHannah HigdonSu LwinAsha MayerAmy MulliganJoe NeyhartOther
