Friend & Family Referrals

Hello and welcome! We created this form so that our students and graduates would have a way to refer friends and family to our program. Below we will ask you for the information we need to start assessing your eligibility. Once you’re done filling it out, hit submit, and we’ll be in touch soon!

Name*
First Last
Consent*
The information provided in this form will be used by Capital IDEA to assess your basic eligibility for the Career Expressway program and to guide you in the application process if you choose to proceed. At that point, you will need to submit additional information and supporting documents to confirm your eligibility. All information provided to Capital IDEA will be kept strictly confidential to protect your privacy and will not be discussed or shared with outside persons or organizations. Click below to give your consent for Capital IDEA to contact you.
I give consent for Capital IDEA to contact me.
I was referred by...*
Please tell us the name of the student or graduate who sent you this link.
About Me
My Career Interests*
Please list your top 1-3 careers. These can be specific degrees or job titles that interest you. If you need to review, our list of sponsored careers can be found in our Career Directory.
First Choice Second Choice Third Choice
My Highest Level of Education*
My Citizenship Status
My Family Size*
Include yourself, spouse/partner, and dependents. If you have roommates, do not include them.
Please enter a number from 1 to 10.
My Place of Residence
My County*
My Address*
Street Address Address Line 2 City State ZIP Code
Income Eligibility
Household Monthly Income*
What is the total monthly income for your household? Include your income and your spouse or partner's income. Do not include the income of your roommates or parents (for young adults living at home).
Please enter a number from 0 to 10000.
Other Income*
Do you receive benefits or other support that be might be counted as income? Ex. child support, food stamps, etc.
- Yes
- No
- Unsure
Contact Information
Phone*
Email*
My Preferred Contact Method*
How would you like us to reach out to you?
- Phone
- Email
Add a Comment (Optional)

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Friend & Family Referrals

About Me

My Place of Residence

Income Eligibility

Contact Information