JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2023-2024 Admission Application
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Legal Last Name
*
Your answer
Legal First Name
*
Your answer
Middle Name
Your answer
Student's Home Address (No P.O. Box)
*
Your answer
Student's City
*
Your answer
Student's Zip Code
*
Your answer
Student's Date of Birth
*
MM
/
DD
/
YYYY
Student's Personal Email Address
Your answer
Student's Cell Phone Number
Your answer
Student's Grade Level for the 23-24 School Year
*
Choose
10
11
12
5th Year Senior
Student's Home High School
*
Choose
Alexandria High School
Elwood High School
Frankton High School
Hamilton Heights High School
Home School
IN Connections Career Academy
IN Options Academy
Lapel High School
Madison-Grant High School
Tipton High School
Tri-Central High School
Student's Career Interest
Your answer
Student's Post Secondary Plan
*
2 Year College Degree
2 Year College Degree + Work
4 Year College Degree
4 Year College Degree + Work
Workforce Entry with Additional Education or Training
Workforce Entry without Additional Education or Training
Military/Armed Services
Apprenticeship
Other:
Required
Next
Page 1 of 4
Clear form
Never submit passwords through Google Forms.
This form was created inside of Hinds Career Center.
Report Abuse
Forms
