Future Student Information

First Name *

Last Name *

Email *

PO Box / Street Address *

Apartment

City *

State / Province (XX) *

Zip / Postal Code *

Country *

Phone (###-###-####)

Cell Number (###-###-####)

First Choice of Major *
Select a Major ADM OF JUSTICE-BAS ADMIN OF JUSTICE ADV HVAC-R TECH ADV MFG TECHNICIAN ADV MFG TECHNOLOGY ADV MFG&DESGN TECH AGEC-A CERT AGEC-B CERT AGEC-S CERT ART-GENERAL AUTO SERV CONSLTNT AUTO SERV TECHNLGY AUTOMOTIVE MAINT AUTOMOTIVE TECHNIC BASIC MARKETG MGMT BIOLOGICAL SCIENCE BOOKKEEPING BUS ENTR SPECIALST BUS ENTREPRENRSHP BUS OFFC ASSISTANT BUS PROJ MGMT FUND BUS TECH SPECIALST BUSINESS BUSINESS ADMIN BUSINESS MANAGEMNT CADD TECH LEVEL I CADD TECH LEVEL II CADD TECHNOLOGY CDL - COM DRVR LCN CHEMISTRY COMMUNICATION STUD COMP INFO SPECLST CONSTRUCTION TECH COS/HAIRSTYLIST COS/NAIL TECHNICIA COSMETOLOGY COSMETOLOGY INSTRU CULINARY FUNDAMENT DATABASE SUPPORT DENTAL ASSISTING DIESEL TECHNOLOGY EARLY CHILDHOOD ED ECE-BAS TRACK EDUCATION-ELEM EDUCATION-SECOND ELEC & INSTR TECH ELECT FUNDAMENTALS EMT EMT-PARAMEDIC ENGINEERING ENGLISH ENVRNMNTL TCHNLGY FIRE SCIENC-LVL II FIRE SCIENCE FIRE SCIENCE-LVL I FIRE SERVICE TRAIN FIRE SRVC-ADVANCED FIREFIGHTING-BASIC FOOD CROP HORTICUL FORESTRY GEN BUSINESS SKILL GENERAL BUSINESS GENERAL STUDIES GENRL TECHNCL STUD GEOLOGY GRAPHIC DESIGN HEALTH & PHYS EDUC HEALTH CARE FOUND HISTORY HVAC-R HVAC-R COMM TECH HVAC-R TECHNOLOG INDUSTRL PLNT TECH IT SUPPORT PROFESS LANGUAGES LAW ENFORCEMENT LIBERAL STUDIES LICENSD PRAC NURSE MACH SHOP TECHNLGY MAJOR APP REPAIR MANAG INFO SYSTEMS MASONRY MATHEMATICS MED CODE&BILL SPEC MEDIA COMMUNICATNS MEDICAL ASSISTANT MEDICAL RECORDS SP MINING/INDST TECH MUSIC NURSING NURSING ASSISTANT ORGANZTNL LEADRSHP ORN HORT&LAND TECH PARAMEDICINE PATIENT CARE TECHN PERSONAL INTEREST PERSONAL TRAINER PHARMACY TECHNCIAN PHLEBOTOMIST TECH PHYSICS POLITICAL SCIENCE PRE-APPRENT CARPEN PRE-CHIROPRACTIC PRE-MEDICAL SCIENC PRE-OPTOMETRY PRE-PHARMACY PRE-PHYSICAL THRPY PROGRMNG & IT SUPP PSYCHOLOGY REG PEACE OFFR TR RENEW SUST ENERGY RENEWBL SUS ENERGY RETAIL MANAGEMENT SM BUS PROPRIETOR SMALL BUS MGMT SOCIOLOGY SPORTS MED PROFESS SYS ADMIN & NETWRK THEATRE ARTS THEATRE PRODUCTION UNDECLARED MAJOR UPDATING VOC SKLS VEHICLE MAINT TECH WELDING FOR INDUS WELDING TECHNOLOGY WELDING/MFG FUND WILDLAND-FIREFGHTR WILDLIFE BIOLOGY

High School Name *

Grad Year (####) *