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USVI Application form
Name
First
Last
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
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Congo
Congo, Democratic Republic of the
Cook Islands
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Croatia
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Curaçao
Cyprus
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Denmark
Djibouti
Dominica
Dominican Republic
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Egypt
El Salvador
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Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
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Guinea
Guinea-Bissau
Guyana
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Heard Island and McDonald Islands
Holy See
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Hungary
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Indonesia
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Iraq
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Korea, Republic of
Kuwait
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Panama
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Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
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Samoa
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Serbia
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Sweden
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Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
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Tonga
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Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
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United Kingdom
United States
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Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
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Email
Phone
Choose Your Program
Medical Biller
Outpatient Coder
Inpatient Coder
Do you have a High School Diploma or Equivalent (Or are you in the process of acquiring)
Yes
No
If you are interested in Funded programs at no cost to you, please complete the following
High School Diploma or Equivalent
Yes
No
Social Security Card
Yes
No
Last Year's Tax Return
Yes
No
Proof of Physical Address
Yes
No
Proof of Citzenship
Yes
No
Proof of Income
Yes
No
Proof of Selective Service Registration (Males 18-26 years)
Yes
No
Proof of Eligibility to Work in the US
Yes
No
Are you interested in 1 of the 3 Following Services/Programs?
Ages 16-24 Funding
Ages 24+ Funding
Dislocated Worker Funding
Are you interested in any of the Following Support Services?
Disability Related Services (if selected an employment advocate will contact you about your specific barrier of learning)
Childcare
Transportation
In order to serve you in a timely manner, we ask that you be prepared to submit the above listed documents upon request
Public Notification Policy
(Required)
Welcome to M1 Enterprises. We strive to maintain transparency and safeguard your privacy. This disclaimer aims to inform you about the usage of your personal information on our platform.
Non-Disclosure of Personal Information: We want to assure you that we will not sell, rent, or disclose your personal information to any third parties without your explicit consent. Your privacy is of utmost importance to us.
Collection of Personal Information: When you interact with our website, we may collect certain personal information such as your name, email address, contact number, and educational background. This information is voluntarily provided by you during the registration or inquiry process.
Use of Personal Information: We may use your personal information for internal purposes, such as improving our services, providing relevant information and updates about our Medical Career Training programs, and responding to your inquiries or requests. Additionally, we may also use your information for promotional purposes to offer you opportunities, discounts, or special offers related to our training programs.
Opting out of Promotional Communications: We respect your preferences. If you do not wish to receive promotional communications from us, you can easily opt out by following the unsubscribe instructions provided in the communication or by contacting us directly. Please note that even if you opt out of promotional communications, we may still send you important administrative messages regarding your account or our services.
Security Measures: We have implemented appropriate security measures to protect your personal information from unauthorized access, alteration, or disclosure. However, please be aware that no data transmission over the internet or electronic storage method is entirely secure. Therefore, while we strive to protect your personal information, we cannot guarantee it’s absolute security.
Third-Party Links: Our website may contain links to third-party websites or resources. Please note that we are not responsible for the privacy practices or content of these external sites. We encourage you to review the privacy policies of those websites before providing any personal information.
Legal Requirements: We may disclose your personal information if required to do so by law or in good faith belief that such action is necessary to (a) comply with legal obligations, (b) protect and defend our rights or property, (c) investigate potential violations related to our Terms of Service, or (d) protect the safety of our users or the public.
I agree to the Public Notification Policy