CDL Program Application

CDL Program Application

Admissions Requirements:

18 years or older | Apply for Broward College Student ID# | High School Diploma or GED |

Driver's License | DOT Physical | Drug Screening | CDL Permit | FL DMV Record

First Name*

Last Name*

Telephone Number*

E-mail Address*

Verify email is correct before submitting!

Residential Zip Code*

Gender*

Male

Female

18 years or Older?*

Yes

No

Please select the age range that applies to you.*

18 - 20

21 - 25

26 - 33

34 - 40

41 - 48

49 - 54

55+

Ethnicity*

Yes, Hispanic/Latino

No, Not Hispanic/Latino

Race*

Native American or Alaska Native

Asian

Black or African American

Native Hawaiian or other Pacific Islander

White

Other

Legal Status*

US Citizen

Permanent Resident Alien

Non-Resident Alien

Military Status*

Verification will be conducted at the time of enrollment.

Select

High Diploma/GED*

HS Diploma

GED

Have you been a Florida resident for more than a year?*

Yes

No

Do you have a Broward College student ID#?*

Yes

No

Enter you Broward College Student number.*

Are you employed?*

Yes

No

Are you currently receiving unemployment?*

Yes

No

What is your hourly wage?*

Verification will be conducted at the time of enrollment.

How many hours do you work weekly?*

Do you receive government assistance?*

Yes

No

Please select which ones apply.*

You will need to provide proof at the time of enrollment.

SNAP benefits

Temporary Cash Assistance

Refugee Services

Medicaid

Disability

Housing Options Program

What is your family/household size?*

Single with no dependent select "1".

1

2

3

4

5

6

7

8

9

10

Emergency Contact 1*

Name / Phone Number

Emergency Contact 2*

Name / Phone Number

Thank you...

You will receive an email with the admission instructions and documents required to enroll in the CDL Program.

Send me a copy of my responses

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