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Full Name (First, Last)
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Birthdate
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Address
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City
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State
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Zip Code
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Phone
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Email address (please do not use a high school email address)
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High School
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High School Graduation Year
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Date you plan to begin at Southwest Tech
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Spring 2012
Summer 2012
Fall 2012
Spring 2013
Summer 2013
Fall 2013
Spring 2014
Summer 2014
Fall 2014
Spring 2015
Summer 2015
Fall 2015
Spring 2016
Summer 2016
Fall 2016
Spring 2017
Summer 2017 or Beyond
Academic Program of Interest
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Choose Academic Program(s) of Interest
Accounting
Accounting Assistant
Administrative Professional
Agribusiness/Science Technology
Agriculture Power & Equipment Technician
Auto Collision Repair and Refinish Technician
Automotive Technician
Barber/Cosmetologist
Bricklaying and Masonry
Building Trades - Carpentry
Business Management
Child Care Services
Clinical Labratory Technican
CNC Setup/Operator
Criminal Justice - Law Enforcement
Culinary Management
Culinary Specialist
Dairy Herd Management
Dental Assistant
Early Childhood Education
Electrical Power Distribution
Electro-Mechanical Technology
Engineering Technologist
Esthetician
Farm Business & Production Management
Golf Course Management
Graphic & Web Design
Human Services Associate
Information Technology - Computer Support Specialist
Information Technology - Network Communication Specialist
Information Technology - Web Analyst/Programmer
Medical Assistant
Medical Coding Specialist
Medical Transcription
Midwife (Direct Entry)
Nursing Assistant
Nursing - Associate Degree
Office Aide
Office Support Specialist
Physical Therapist Assistant
Welding
Individualized Technical Studies
Criminal Justice - Corrections (Shared Program with Northeast Wisconsin Technical COllege)
Dental Hygenist (Shared Program with Madison Area Technical College)
Pharmacy Technicial (Shared Program with Lakeshore Technical College)
Radiography (Shared Program with Madison Area Technical College)
Respiratory Therapist (Shared Program with Western Technical College)
OR Apprenticeship Program of Interest
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Choose Apprenticeship Program of Interest
Construction Electrician
Industrial Electrician
Plumbing
Technical Studies - Journeyworker Associate of Applied Science
OR Community Education
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Choose Community Education Area of Interest
Basic Adult Education
Business/Professional Development
Computer Technology
Industrial
Health
Life & Leisure
Public Safety/Transportation
OR OTHER Area of Interest (please specify)
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How did you find out about Southwest Tech
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College Fair
High School Staff
Friend/Family Member
High School Visit
Internet Search
Mailing
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