ACC CTE Enrollment Form 2018-2019
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.
* Required
Home High School
*
Choose
Calumet
Clark
Edison
Gavit
Griffith
Hammond High
HAST
Highland
Lake Central
Morton
Munster
Whiting
Home School
Other
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
*
MM
/
DD
/
YYYY
Legal Sex/Gender
*
Choose
Male
Female
Home Street Address
*
Your answer
City
*
Your answer
State
*
IN
Other:
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
Ethnicity
*
Either: 1=Hispanic or 2=Other
1
2
Race/Ethnic Group
*
Choose
American Indian/Alaskan
Asian Pacific Islander
African American
Hispanic
White, not Hispanic
Multi-race
Grade you will enter in the 2018-2019 school year (Next year).
*
Choose
10
11
12
Next
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