Lewis & Clark Career Center Application
LEWIS & CLARK CAREER CENTER PROGRAMS ARE OFFERED WITHOUT REGARD TO RACE, NATIONAL ORIGIN, SEXUAL ORIENTATION, GENDER OR DISABILITY. LEWIS & CLARK CAREER CENTER IS ONLY FOR HIGH SCHOOL STUDENTS THAT LIVE IN ST CHARLES COUNTY MISSOURI.
Sign in to Google to save your progress. Learn more
Student Last Name *
Student First Name *
Student date of birth *
MM
/
DD
/
YYYY
Student T-shirt size *
Student email *
Address *
City *
State *
Zip *
Student Cell Number *
Parent/Guardian Names *
Parent Cell Number *
Parent Email *
Alt. Parent Cell Number
Alt. Parent Email
School District *
Current High School *
Current grade in school *
Do you have an IEP? *
Do you have a 504? *
Please select your first choice program ( pick 1) *
Please explain why you selected this as your first choice:
Please select your second choice program (pick 1) *
Please explain why you selected this as your second choice:
Please select your third choice program (pick 1)
Please explain why you selected this as your third choice:
Have you visited Lewis and Clark campus?
Clear selection
How did you hear about Lewis & Clark?
List any family members who attended L & C:
I am seeking application for Lewis & Clark Career Center. I have discussed my intent with my parents/guardians. By submitting this application I grant my high school permission to issue L & C my records including transcript, attendance, discipline, etc. for evaluation.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of St. Charles RVI Schools. Report Abuse