Canton City School District                         Adult Career & Technical Education       Admission Application
Background Information
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521 Tuscarawas Street W., Canton, OH 44702 ~ (330) 438-2556  ext:11504
First name: *
Middle Initial:  *
Last Name: *
Any Previous Names or Aliases: 
Birthdate MM/DD/YYYY (Allowed to type "prefer not to answer".) *
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City:  *
State:  *
Zip Code:   *
Email Address:  *
Cell Phone: *
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Other Phone:
Gender:  *
Are you a US Citizen?  *
If you answered "No" to the question above, please explain.
Are you a Veteran? *
I would like to enroll in the following program:  *
Desired Enrollment Date:
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