Tri-County Career Center Application
STUDENT INFORMATION
The STUDENT should complete all information on the application.

PLEASE BE AS DETAILED AS POSSIBLE IN YOUR RESPONSES

Student's First Name *
Your answer
Middle *
Your answer
Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Student's Phone Number
Your answer
Student's Email Address
Your answer
Shirt Size *
PARENT INFORMATION
Mother's/Guardian's Name
Your answer
Mother's Address (if different from student)
Your answer
Mother's Phone Number(s)
Your answer
Mother's Email Address
Your answer
Mother's Employer/City of Employment
Your answer
Father's/Guardian's Name
Your answer
Father's Address (if different from student)
Your answer
Father's Phone Number(s)
Your answer
Father's Email Address
Your answer
Father's Employer/City of Employment
Your answer
ENROLLMENT INFORMATION
At what school are you currently enrolled? *
Present Grade Level *
Date of Birth (mm/dd/yy) *
Your answer
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. *
Your answer
2nd Program Choice *
Please explain your 2nd choice. *
Your answer
3rd Program Choice *
Please explain your 3rd choice. *
Your answer
Is there anything else you would like us to know about you (THIS IS A GOOD OPPORTUNITY TO EXPLAIN ANY ATTENDANCE, DISCIPLINE OR OTHER ISSUES THAT MAY PRESENT THEMSELVES AND ALSO FOR US TO LEARN A LITTLE MORE ABOUT YOU)?
Your answer
SIGNATURES
IMPORTANT NOTE: By signing below, you give permission to release transcript, standardized assessment scores, and other student records to Tri-County Career Center for the above named student.

Upon submitting this application, the affiliate home school counselor will be contacted as well as the school counselor at Tri-County Career Center.

STUDENTS AND PARENTS THAT SIGN BELOW AGREE THAT UPON ACCEPTANCE, THE STUDENT WILL ATTEND FOR AT LEAST THE FIRST WEEK OF SCHOOL AT TRI-COUNTY.

Student Signature (Please type your full name) *
Your answer
Parent Signature (Please type your full name) *
Your answer
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