Adult Education Admission Application
500 Glamorgan Street Alliance, Ohio 44601 Phone: (330)829-2267 Fax: (330)821-3573

Alliance Career Center (ACC) is an equal education and employment institution. ACC admits students of any race, color, national or ethnic origin, religion, sex, age, and disability to all the rights, privileges, programs, and activities generally accorded or made available to students at ACC. It does not discriminate on the basis of race, color, national or ethnic origin, religion, sex, age, disability or any other characteristic provided by state or federal law in the administration of its educational policies, admissions policies, scholarship and loan programs, and other school administrative programs.
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Email *
Today's Date: *
First Name: *
Middle Initial: *
Last Name: *
Any Previous Names or Aliases:
Birthdate MM/DD/YYYY (Allowed to type "prefer not to answer".) *
Street Address (House Number, Street Name, Street Direction if applicable): *
City: *
State: *
Zip Code: *
Email Address: *
Cell Phone: *
Can you receive text messages? *
Other Phone:
Gender: *
Please note that certain felony (and a few select misdemeanor) convictions may prevent you from earning a certification in certain fields. Please call our office to discuss any convictions and which program will be the best fit. Office: (330) 829-2267
Program(s) of Interest:
Once we receive your application you will receive an email from us regarding the program that you selected. Please check your spam folder.
I would like to enroll in the following program: *
Desired Enrollment Date: *
Secondary Person to Contact about your Application if you cannot be reached: (Their Name, Their Cell Phone, Their Relationship to you) *
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