Tri-County Career Center Application
Application for the 2021-2022 Academic School Year. Please fill out as much as possible.
STUDENT INFORMATION
The STUDENT should complete all information on the application.

PLEASE BE AS DETAILED AS POSSIBLE IN YOUR RESPONSES
Student's First Name *
Middle *
Last Name *
Street Address *
City *
State *
Zip Code *
Student's Phone Number
Student's Email Address
Shirt Size *
PARENT INFORMATION
Mother's/Guardian's Name
Mother's Address (if different from student)
Mother's Phone Number(s)
Mother's Email Address
Mother's Employer/City of Employment
Father's/Guardian's Name
Father's Address (if different from student)
Father's Phone Number(s)
Father's Email Address
Father's Employer/City of Employment
ENROLLMENT INFORMATION
At what school are you currently enrolled? *
Present Grade Level *
Date of Birth (mm/dd/yy) *
PROGRAM CHOICES
If you need more information on any of the programs we currently offer at Tri-County Career Center, please refer to our website www.tricountyhightech.com
1st Program Choice *
Please explain why you selected the above lab as your 1st choice. Make sure you are as detailed as possible. *
2nd Program Choice *
Please explain your 2nd choice. *
3rd Program Choice *
Please explain your 3rd choice. *
Is there anything else you would like us to know about you? This is a good opportunity to explain any attendance, discipline, or credit issues that may show up on our review. It's also a nice way for us to learn a little more about you!
Is there a current student at Tri-County that talked to you about their program? If so, what is his/her name? We would like to show our thanks to them!
Student Signature (Please type your full name) *
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