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 ADMIN PROFESSIONAL ADV HVAC-R TECH ADV MFG TECHNICIAN ADV MFG TECHNOLOGY ADV MFG&DESGN TECH AGEC-A CERT AGEC-B CERT AGEC-S CERT ANTHROPOLOGY ART-GENERAL AUTO SERV CONSLTNT AUTO SERV TECHNLGY AUTOMOTIVE MAINT AUTOMOTIVE TECHNIC BIOLOGICAL SCIENCE BOOKKEEPING BUS OFFC ASSISTANT BUS PROJ MGMT FUND BUS TECH SPECIALST BUSINESS BUSINESS ADMIN CABLE COMM INSTALL CADD TECH LEVEL I CADD TECH LEVEL II CADD TECHNOLOGY CHEMISTRY COMMUNICATION STUD COMP INFO SPECLST COMP INFO SYSTEMS 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 LANGUAGES LAW ENFORCEMENT LIBERAL STUDIES LICENSD PRAC NURSE MACH SHOP TECHNLGY MAJOR APP REPAIR MASONRY MATHEMATICS MED CODE&BILL SPEC MEDIA COMMUNICATNS MEDICAL ASSISTANT MINING/INDST TECH MUSIC NURSING NURSING ASSISTANT ORN HORT&LAND TECH PARAMEDICINE PATIENT CARE TECHN PERSL CMP SYST/NET 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 PSYCHOLOGY REG PEACE OFFR TR RENEW SUST ENERGY RENEWBL SUS ENERGY RETAIL MANAGEMENT SM BUS PROPRIETOR SMALL BUS MGMT SOCIOLOGY SPORTS MED & REHAB SPORTS STUDIES AA THEATRE ARTS 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 (####) *