BCAVTS Adult Education Application
Event Timing: 2019 Spring Classes
Event Address: 210 Campus Lane, Butler, PA 16001
Contact us at (724) 282-0735 x 242 or burks@butlertec.us
Last Name *
Your answer
First Name *
Your answer
Middle Initial *
Your answer
Telephone Number *
Your answer
E-mail Address *
Your answer
Street Address *
Your answer
City *
Your answer
Zip *
Your answer
Class Selection *
Class Start Date *
Reason for taking the course? *
Required
Date of Birth *
MM
/
DD
/
YYYY
What school district do you reside in? *
Your answer
The following information will assist the school in completing mandated Pennsylvania Department of Education/Bureau of Career & Technical Education Reports:
Gender *
Race *
Special Populations
Disabled *
Displaced Homemaker *
Educationally Disadvantaged *
Economically Disadvantaged *
Limited English Proficiency *
Single Parent *
Note 1: Please mark the start date on your calendar as you will be notified via e-mail only if class is cancelled due to insufficient enrollment. Evening school programs do not run if BCAVTS is closed due to inclement weather. Note 2: Refund Policy-All fees returned if class is cancelled due to insufficient enrollment or other administrative reason. All fees, less $5.00 for registration cost, returned if you cancel and notify the school prior to start date. One-half of registration will be returned if you cancel and notify the school within the first two weeks of class. No refunds after second week of class. Note 3: Due date for class payment will be e-mailed to you. The Butler County Area Vocational-Technical School will not discriminate on the basis of race, color, national origin, sex or handicap in its admission procedures, educational programs and activities or employment practices as required by Title VI, Title IX, and Section 504. For information regarding Civil Rights or grievance procedures, contact the Butler County AVTS Title VI, IX, and Section 504 Coordinator at 210 Campus Lane, Butler, PA 16001. For information regarding services, programs and facilities that are accessible to and usable by handicapped persons, please contact the Special Needs Facilitator at 210 Campus Lane, Butler, PA 16001. Telephone (724) 282-0735. Signature Section: Your submission of this form is your electronic signature. This indicates you have read the above information.
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