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Automotive/Collision Repair
Name (First, Middle, and Last) *
Your answer
Parent/Guardian Name *
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Base School *
Grade *
Address (Street, City, State, Zip Code) *
Your answer
Phone Number *
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Email Address *
Your answer
GPA *
How many days of school did you miss last year? *
Explain in 2-3 sentences why you want to take this course. *
Your answer
Student ID Number (Lunch Number) *
Your answer
Provide the name of a teacher at your base school that can provide a character reference. *
Your answer
Provide the teacher’s email address. (Ex. John Smith-Jsmith@bedford.k12.va.us) *
Your answer
Is this BSTC course your 1st, 2nd, or 3rd choice? *
How did you hear about this program? *
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