PDA Student Loan ApplicationComplete this form in its entirety to submit your application for financial aid."*" indicates required fieldsStep 1 of 812%Your Name* First Last As it appears on your Government-issued ID Misspelling of names could delay enrollment and or results from being submitted to the government, employees, etc upon completion of the course.Your Email* Enter Email Confirm Email Ensure the email you are registering with is for the student, as this is how we will have all communications from the school sent out including enrollment for online courses.Phone*We need a valid number on file for all students.Preferred Method of Contact Email PhoneWe you referred by someone?* Yes NoWho was your referrer?*The name of your referrer is required. If your employee is sponsoring your tuition place their names in the referrer section. If you don’t remember the person’s name, put follow-up in the field.Your Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth* MM slash DD slash YYYY DL Number*Verify Driver’s License number is correct before submitting.State*Which state is your ID registered?Will you be applying for financial aid?* Yes NoIf you are applying for scholarships, tuition discounts, grants, etc select this field. If you are paying full tuition you may bypass this field.SSN OR ITIN*Must be filled regardless if you are applying for financial aid.Are you a US Citzen?* Yes No OtherEthnicity Hispanic or Latino Non-Hispanic or LatinoEthnicity: The following race and ethnicity questions are requested to assist the University in complying with Federal guidelines (these questions are optional).Race American Indian or Alaska native Asian Black or African American Native Hawaiian or other Pacific Islander White or Caucasian OtherRace: The following race and ethnicity questions are requested to assist the University in complying with Federal guidelines (these questions are optional).Highest Degree Earned* High School/Equivalent Associate’s Bachelor’s Master’s or Higher OtherEmployment Status* Employed Self Employed Retired Unemployed OtherName of Employer*If not currently employed put name of previous employment if applicable, if no previous employment place N/AAddress above MUST match your address on photo license ID. Does the address you inputted above match your photo ID you will be submitting today? YES NOAddress Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Enter the address as it is on your Unexpired Drivers License or CDL. You will be required to upload ID later in the application.Employment Status* Employed Full-Time Employed Part-Time Self Employed Contractor Unemployed Student OtherThis field is not optionalName of Employer*If not currently employed put name of previous employment if applicable, if no previous employment place N/AName of Business or 2nd place of employment*If not currently employed put name of previous employment if applicable, if no previous employment place N/AHow are you paid?* W-2/Paystub 1099/Settlement Invoice OtherThis field is not optionalLength of Employment*If not currently employed put length of previous employment if applicable, if no previous employment place N/ALast Date Worked* MM slash DD slash YYYY If you are presently working select today.Annual Income*Amount of your share of monthly rent or mortgage*Enter in dollars and cents for example 450.98Do you have any State or Federal Tax Liens filed against you or your property?* Yes NoHave you defaulted on or are you delinquent on any student loans?* Yes NoDo you have delinquent child support due for which there is a judgement against you?* Yes NoDo you have an active unresolved bankruptcy ongoing?* Yes NoWhich financial aid options do you want to be considered for?* Student Grants Student Loans Scholarships Mentorship Apprenticeship OtherWhich financial aid options do you want to be considered for?*Student GrantsStudent ScholarshipsStudent LoansMentorshipApprenticeshipVolunteer/Work OptionsWhich Campus are you enrolling for?*Missouri City, TXBryan, TXLafayette, LAOnlineWhich course are you enrolling in?*Commercial Licensed Driver Class ACommercial Licensed Driver Class BTrucking Fleet Business ManagementSelect the main course you are enrolling in. All courses require a $100 enrollment fee that will be applied via tuition invoice. Enrollment fees are non-refundable.Which Orientation would you like to attend?* Virtual (Self-Paced) Live via Zoom OtherAll students are required to attend orientation.Do you have your Permit?* Yes No Not ApplicableIf you have a CLP select yes otherwise select no or not applicable.Have you completed a DOT Drug screening within the past 7 days?* Yes No Not ApplicableThis will not affect your enrollment into the CDL course.Do you have your DOT Medical Card?* Yes No Not ApplicableIf you have not taken your DOT physical select no.Have you had a DOT Medical Card in the past?* Yes No Not ApplicableFor which CDL course start date are you applying for?*Dec 5, 22Jan 2, 23Jan 23, 23Feb 13, 23March 13, 23April 3, 23ClassA CDL M-F 3-week term hybrid 4 hr blocks part-time schedule from 8 am -9 pm ($3500.00)For which CDL course start date are you applying for?*Dec 5, 22Jan 2, 23Jan 23, 23Feb 13, 23March 13, 23April 3, 23ClassA CDL M-F 3-week term Full-time schedule from 8 am -4 pm ($4500.00)For which CDL course start date are you applying for?*Dec 5, 22Jan 2, 23Jan 30, 23Feb 27, 23March 27, 23April 24 23ClassA CDL M-F 4 week term hybrid Full-Time schedule from 8 am -4 pm ($5500.00)For which CDL course start date are you applying for?*Nov 14, 22Nov 28, 22Dec 12, 22Jan 2, 23Jan 16, 23Jan 30, 23Feb 13, 23Feb 27, 23March 6, 23March 20, 23Class B CDL M-F 1-week term hybrid part-time M-F 4 hr block from 8 am -9 pm ($1500.00)For which CDL course start date are you applying for?*Nov 14, 22Nov 28, 22Dec 12, 22Jan 2, 23Jan 16, 23Jan 30, 23Feb 13, 23Feb 27, 23March 6, 23March 20, 23Class B CDL M-F 1-week term hybrid full-time M-F from 8 am -4 pm ($2500.00)For which CDL course start date are you applying for?*Nov 5, 22Dec 3, 22Jan 7, 23Feb 4, 23March 4, 23Apri 1, 23Class A Sat-Sun 5-10-week term ($3500-5500) Class B Sat-Sun 3-5-week term ($1500-2500)DOT Drug ScreenAccepted file types: jpg, png, pdf, Max. file size: 256 MB.Upload a front and back copy of your DOT Drug screen, If you are enrolled in any CDL/ELDT driving courses this is required. If you have not completed your screening as of today, you can submit it directly with admissions.DOT Medical CardAccepted file types: jpg, png, pdf, Max. file size: 256 MB.Upload a copy of your DOT medical card. If you are enrolled in any CDL/ELDT driving courses this is required. If you don’t have it at this time, you can submit to admissions.Valid State ID* Drop files here or Select filesAccepted file types: jpg, png, pdf, Max. file size: 256 MB, Max. files: 2. Upload a front and back copy of your State ID, Drivers License, CDL, or CLP (Commercials Learners Permit) If you are enrolled in ELDT or any CDL courses this is required.Terms Of ServiceAgreement* I agree to the terms of service1. Prospective students of Eliteblackboard & Platinum Driving Academy should read these terms and conditions carefully prior to submitting an application. If you are admitted to Eliteblackboard & Platinum Driving Academy you will be bound by these terms for the duration of your Program. In addition to these terms and conditions, as a student at Eliteblackboard & Platinum Driving Academy, you will be bound by the rules and regulations governing Eliteblackboard & Platinum Driving Academy, as those may be amended from time to time. 2. Eliteblackboard & Platinum Driving Academy reserves the right to amend these terms and conditions from time to time. By accepting these terms and conditions you acknowledge and agree to comply at all times with the then-current terms and conditions. 5. Admission: If you are admitted to Eliteblackboard & Platinum Driving Academy you will receive a written offer letter with details and instructions on accepting the offer, paying the Program deposit and arriving on campus. 6. Tuition and fees payment: Following payment of the deposit, you must pay the remaining outstanding balance shown on the invoice by the following posted payment deadline of the Program and semester in which you will enroll 7. Refunds and Cancellations Policy: All sales are final. We do not offer refunds on merchandise, seminars, webinars, workshops, courses, etc. For a more detailed outlook of our policy visit. https://www.eliteblackboard.com/terms-of-service/ PRIVACY POLICY This privacy policy sets out how the information you provide is used when you submit your information through the use of this Web Site. The Company and its affiliates are committed to ensuring that your privacy is protected. Collection & Use of Information. The Company and its affiliates collect and store the information you enter in the application or lead form submitted for purposes of providing you with information concerning products and services offered by the Company, its affiliated companies, or other third party service providers. Company and its affiliates may use the information provided by you for internal review and strategy development. You may be contacted by a representative of Company, an affiliated company, or a third party service provider concerning products or services, using the information you have provided through use of this Web Site. Links to Other Websites. The Company Web Site may contain various links to allow you to visit other websites of interest. Please note that Company does not have any control over the linked website(s) and thus disclaims any and all responsibility for the protection of any information you provide while visiting such sites, as such sites are not governed by this privacy policy. Users are advised to review the privacy policies and terms and conditions of use on any site visited by user through any link located on the Company Website. Security. The Company and its affiliates maintain industry-standard security measures to protect against unauthorized dissemination of information collected from your application or lead form.EmailThis field is for validation purposes and should be left unchanged.Share this:TwitterFacebookLike this:Like Loading...
