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Program Application

Delta College - General Motors - ASEP Automotive Service Educational Program Application Section 1 to be completed by Applicant

Candidate Name ___________________________________________________________________ Last

First

Middle

Address ___________________________________________________________________________ Street

Phone (

)

City

State

Zip

Delta ID # ___________________ Today’s Date _______________________

Do you have a valid Michigan drivers’ license? Yes ____ No ____ If yes, enter your license number ________________________________________________ Please provide a copy of your driving record from Michigan Secretary of State. _______

Educational Background High School from which graduated ____________________________________ Year ___________ Or year GED completed ______________________________________________________________ Did you participate in a High School Automotive Program? Yes ______ No ______ If yes indicate below the type of Automotive Program: Industrial Arts _____________________ or Career Center ___________________________________ How many semesters? __________ Name of Teacher _____________________________________ Articulated credit for any automotive classes? _______________________________________ Have you attended any college classes? Yes _____

No _____

If Yes, where? ______________________________________ Dates of Attendance _____________ Credit hours earned ____________ Classes taken _______________________________________________________________________

Other educational experience (military schools, seminars, etc.) ____________________________

Work Experience (Most recent within the past two years) 1.

Place of employment _____________________________________________________________

Immediate Supervisor _____________________Phone (____) 2.

Place of employment _____________________________________________________________

Immediate Supervisor ___________________________ Phone ()__________________

Career Interests Write a clear, definitive statement of your career interests.

I hereby certify that the foregoing statements are true and correct. I understand that if I have knowingly provided incorrect or false information, I may forfeit the opportunity to be selected as a participant in the Automotive Service Educational Program. In addition, I authorize the Delta College GMASEP coordinator to release any placement test scores, college transcripts, attendance records and/or other academic information, to my current or potential dealership/PSC or General Motors officials involved with the Automotive Service Educational Program. I also authorize the use of any photos taken of me to be used for reporting/marketing of Delta College, Delta College GMASEP Program and by any General Motors or ACDelco partner.

Applicant Signature

(If you do not have a dealership or PSC Center considering sponsorship,

please send your application to the GMASEP Coordinator at Delta College.)

Section 2 to be completed by GM Dealership or PSC Center Representative ______ Yes, I am considering providing sponsorship to this applicant. (Expression of interest, not intent) If yes, ask applicant for high school transcript.

Dealer/PSC Authorized Representative

Title

Dealership/PSC Name Address City

State

Zip

Note: On completion of application to this point, applicant should call the Delta College GMASEP Coordinator to schedule an appointment. Bring application to the meeting.

Section 3 to be completed by Delta College Representative I have interviewed the Automotive Service Educational Program (ASEP) applicant for consideration for appointment to the Program. The ASEP applicant has been provided with the information needed to complete the admission requirements to Delta College.

(989) 686-9351

Delta College ASEP Coordinator

Required entry level automotive courses: ASEP 100_________ASEP 101________ ASEP 102_______ ASEP 103 __________

ASEP 104 _ASEP 105 ASEP 106 _______ASEP 107 __________

ASEP 108 _________ASEP 110 ________ ASEP 149 (ASE G1) _______

Section titled “ASEP 108 _________ASEP 110 ________ ASEP 149 (ASE G1) _______”

I have reviewed the Automotive Service Educational Program requirements with the applicant for the Delta College – General Motors ASEP Program. ______ Yes I can recommend this student for placement in GM ASEP at this time. ______ No I cannot recommend this student for placement in GM ASEP at this time.

If no at this time, student should concentrate on the following:

Delta College ASEP Coordinator

______________ (989) 686-9351

Note: Applicant is to return this application to recommending dealer.

Section 4 to be completed by GM Dealership/ PSC Center during Second Interview AFTER applicant has met with the GM-ASEP Coordinator Dealership: _____________________________________ Location: ____________________ Dealership Comments:

  1. Education and Training: Is candidate’s education, training and interest job related, and do they match qualifications for admission to GMASEP?
  1. Work Experience: Does candidates’ experience on other jobs relate to the work involved in this program?
  1. Skills and Abilities: Does candidate possess skills and abilities related to ASEP course curriculum?
  1. Career Interests: Are the candidate’s goals and aspirations in harmony with the opportunities available in Automotive Service?
  1. Employability: Does candidate have necessary qualifications for employment (other than the skills outlined in curriculum)?
  1. Other factors: Comment on any other factors brought out in the interview which could have an effect on the candidate’s suitability for ASEP.

  1. Do you recommend this candidate for the ASEP Program?

_____ Yes

_____ No

__________ Yes, I will sponsor this applicant.

  1. Please provide the following information: Name of GM DMA __________________________________________________________________ Dealership/PSC Center Name _____________________________________________________ Service Manager Name Email______ Mentor’s Name ______________________________________________________________________

Dealer-PSC/ Authorized Representative Signature

Title

Following Dealership approval, please return to: Delta College Jim Miller, ASEP Coordinator jamesmiller@delta.edu 1961 Delta Road University Center, MI 48710 Section 5 to be completed by ASEP Coordinator Check appropriate space(s): ______ Yes, applicant has met all the requirements for consideration for appointment to the Automotive Service Educational Program. ______ No, applicant did not meet all the requirements for consideration to the Automotive Service Educational Program. Reason: ________________________________________________________________________

_____ Yes, applicant was appointed to the Automotive Service Educational Program. Please notify student, dealer, service manager, DTC, and DMA of selection.

ASEP Coordinator Signature

IT IS THE POLICY OF DELTA COLLEGE NOT TO DISCRIMINATE ON THE BASIS OF RACE, COLOR, RELIGION, SEX, AGE, NATIONAL ORIGIN OR HANDICAP IN ITS EDUCATIONAL PROGRAMS, ACTIVITIES, OR EMPLOYMENT.

Delta College - General Motors - ASEP Automotive Service Educational Program