ACC CTE Enrollment Form 2017-2018
Area Career Center-Career and Technical Education Enrollment Form

**This form is only for ACC Career and Tech Ed (CTE) students from our 11 partner high schools. This is not for ACC University or Adult Education students. It will take approximately 10-15 minutes to complete.

Home High School
Student Legal First Name
Your answer
Student Legal Middle Name
Your answer
Student Legal Last Name
Your answer
Student Social Security Number (NO hyphens or spaces please)
This is required by Federal law. Please do your best to find your SSN and input it.
Your answer
Student Birthdate
Legal Sex/Gender
Home Street Address
Your answer
Your answer
Zip Code
Your answer
Student Cell Phone Number or Home Number
Please--NO hyphens, parentheses, spaces, or periods for all phone numbers. Use format: ##########. If you do not have a personal cell phone, please use your home phone number or the main number to contact you.
Your answer
Emergency Phone Number
Should be different from home phone number. Use format: ##########.
Your answer
Student E-Mail Address
Your answer
Either: 1=Hispanic or 2=Other
Race/Ethnic Group
Grade you will enter in the 2017-2018 school year (Next year).
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