Northland Career Center Application Jacobs III EDUCATION CENTER

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Welcome to Northland Career Center of Platte City, Missouri. Please complete the form in full. Students must be an incoming junior or senior to enroll. If you have any questions, please contact Mr. Webster or Mrs. Walleman at (816) 858-5505.

NCC Mission: To prepare students for a continually changing world by providing relevant experiences.

First Name *

Middle Initial *

Last Name *

Home School *

Pin Oaks Education Center

Select your grade level for next year (2023-2024). *

10 (NCC only accepts 10th graders in the Agricultural Sciences program. No other programs are open to sophomores at this time)

Street Address *

EXAMPLE: 555 Oak Street - Apt 5

City *

Dearborn

Dekalb

Edgerton

Farley

Faucett

Ferrelview

Gladstone

Kansas City

Kearney

Liberty

North Kansas City

Parkville

Platte City

Riverside

Smithville

Weston

Other:

State *

Other:

Zip Code *

Please type your 5-digit zip code. (For example: 64079)

County *

Clay

Platte

Other:

Student HOME Phone *

EXAMPLE: (816) 555-5555 / (Type "N/A" if no student HOME phone)

Student CELL Phone *

EXAMPLE: (816) 555-5555 / (Type "N/A" if no student CELL phone)

Student EMAIL *

EXAMPLE: contact@gmail.com / (Type "N/A" if no student EMAIL)

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