Apply to NRTI | New Reflections Technical Institute

Complete all required fields. Your answers are securely sent to the NRTI admissions portal.

1. Applicant information

First name *Middle initial *Last name *Street address *City *State *ZIP code *Phone number *Other phoneEmail address *Valid driver's license? *Social Security number *Birthdate *

2. Emergency contact and guardian

Emergency contact name *Relationship *Emergency phone *Emergency contact streetCityStateZIP codeParent/guardian name (if under 18)Parent/guardian streetParent/guardian cityParent/guardian stateParent/guardian ZIPParent/guardian phoneOther guardian phoneParent/guardian email

3. Education and program interest

High school diploma or equivalent? *Credential typeHighest educational level *Graduation date *School or GED programSchool citySchool stateProgram of interest *Current enrollment status *Previously applied to NRTI? *Previous application year

4. Background and goals

Justice impacted? *Year of convictionCurrently on parole or probation? *Outstanding warrants? *If yes, please explainDescribe your educational goals *Confident you will graduate? *Do you have a support system? *Likelihood of asking for support *Weekly study time outside class *Currently employed? *Currently receiving Medicaid/Medicare? *Medicaid/Medicare number

5. Referral and community connections

Organizations are recorded only as referral information. They do not change eligibility funders.

6. Residency

Citizenship *Residency status *Missouri resident? *Kansas qualifying county?How long in Kansas?Previous street address (if current address under 1 year)Previous cityPrevious statePrevious ZIP

7. Supporting documents

PDF, Word, JPG, or PNG; 20 MB maximum per file.

Identification card — state-issued IDBirth certificateMost recent transcriptsDriving record dated within 30 daysDiploma / HiSET (GED) certificate

8. Signature

I certify that the information in this application is true and complete. I understand that required credentials must be submitted before an admission decision can be made, and I authorize NRTI to maintain my application records.

Applicant signature (type full legal name) *Date *

I agree that typing my name and submitting this application constitutes my electronic signature.

9. Voluntary information

This section is optional and does not affect admission.

GenderHispanic or Latino?Veteran?Honorable discharge?Veteran status / branchPerson with a disability?Need admissions accommodations?Describe accommodations neededLearning English or limited English?Need language assistance?Describe language assistance needed

Admissions staff will review your application and contact you about next steps.