Request edit access
2023 - 2024 Scott Regional Technology Center Enrollment LATE Application
Please fill out each question completely.  All questions with an * requires an answer.
Sign in to Google to save your progress. Learn more
Last Name *
First Name *
Middle Name
Your High School *
You will be in the __________ grade for the 2023 - 2024 year *
First Program Choice *
Second Program Choice *
Birth Date *
Cell Phone (or a number that you receive calls)
Email Address (one that you check often) *
Parent or Guardian Name *
Parent or Guardian Phone Number
Parent or Guardian Email
Why do you wish to be in this program and how does it relate to your future career plan? (50 words or less) *
Attendance, punctuality, discipline, and past academic achievement are important for success in any SRTC program. Explain any excessive absences, tardies, academic deficiencies or discipline referrals.
I understand that this is a two or four-semester course depending upon the program. Acceptance into, and completion of a program is dependent upon achievement, citizenship, attitude and attendance. By clicking below, I agree to the above statement and that all information in the application is true.
Clear selection
Clear form
Never submit passwords through Google Forms.
This form was created inside of Monett R-1 School District. Report Abuse