Application Form – Patriot Placement Program

Section 1: Personal Information *

Full Name

Date of Birth

Phone Number

Email Address

Current Address

Section 2: Military Service Verification *

Current Status

Active Duty Transitioning Service Member Veteran (separated/retired)

Years of Service

Upload Proof of Service (DD-214, current orders, or equivalent)

Section 3: Education & Background *

Highest Level of Education Completed

Have you completed any construction-related training or certifications?

Yes No

Section 4: Career Interests *

Which areas of construction interest you most? (Check all that apply)

Preferred location(s) for co-op and employment after training

Section 5: Housing & Support Needs *

Will you require housing assistance during the program?

Yes (on-campus housing) Yes (family/off-campus housing) No

Do you require additional support services? (Check all that apply)

Career Coaching Wellness / Mental Health Support Financial Guidance Other

Section 6: Funding & Financial Assistance *

How do you plan to cover tuition and program costs?

Out-of-Pocket (self-pay) GI Bill® Benefits Department of Defense SkillBridge Program COOL Program (Credentialing Opportunities On-Line) Vocational Rehabilitation & Employment (VR&E) Other Military or State Assistance

If out-of-pocket: Estimated payment method

Check Credit Card Payment Plan

Section 7: Resume & Statement of Interest *

Upload Resume (optional but recommended)

Short Essay (250–300 words)

Section 8: Commitment Agreement *

I am committed to completing the Arcadia University Certificate Program.
I am committed to fulfilling my co-op placement with a General Contracting firm.
I am committed to pursuing full-time employment upon successful completion of the program.

I Agree & Submit

Patriot Placement Program – Application Form