NEW STUDENT APPLICATION BLUE RIVER CAREER PROGRAMS NEW STUDENT APPLICATION 2022-2023 Blue River Career Programs Step 1 of 2 50% SECTION ONEStudent Legal Name :* First Last Student Phone Number :*Student Email :* Date of Birth :* Sex :Select OptionFemaleMaleGrad Year :*Select One2023202420252026Home School :*Select OptionSHS – Shelbyville High SchoolTCHS – Triton Central High SchoolSWHS – Southwestern High SchoolMHS – Morristown Jr. Sr. High SchoolWHS – Waldron Jr. Sr. High SchoolStudent Mailing Address :* Street Address City ZIP Code Parent/Guardian Home Address (if different) : Street Address City ZIP Code Father Name :*(If none please put NA) Phone Number :*Email Address :* Mother Name :*(If none please put NA) Phone Number :*Email Address :* Guardian Name :*(If none please put NA) Phone Number :*Email Address :* SECTION TWOChoose your first and second program choices.First Choice ProgramPlease choose your first type of program from the dropdown menu.Select your first choiceAuto Collision RepairAuto Services TechnologyConstruction TradesCriminal JusticeCulinary ArtsDiesel Service TechnologyDigital DesignFire & Rescue IFire & Rescue IIHealth Science IHealth Science II (Capstone)Welding TechnologyWork Based LearningSecond Choice ProgramPlease choose your first type of program from the dropdown menu.Select your second choiceAuto Collision RepairAuto Services TechnologyConstruction TradesCriminal JusticeCulinary ArtsDiesel Service TechnologyDigital DesignFire & Rescue IFire & Rescue IIHealth Science IHealth Science II (Capstone)Welding TechnologyWork Based LearningFootnote Key : * Dual College Credit May Be Available ^ Criminal History Report Required ● Minimum Age Requirement (17 by May 2021) Seniors Only ∆ Minimum GPA 2.5 # Minimum Age Requirement (16 by May 2021) SECTION THREE - Student• Briefly describe why you want to take a career program class :*• List classes you have taken in high school and work experiences which relate to your career program choice :*• Do you have any health problems or physical limitations that Blue River Career Programs should be aware of or may require special accommodations?* No Yes • Please describe :*HiddenSECTION FOUR - Home School CounselorHiddenStudent Legal Name :* First Last HiddenCurrent GPA : HiddenCredits earned : HiddenSTN : Hidden# of days absent year to date : HiddenDiploma Track :Please diploma track from the dropdown menu.Core 40Academic HonorsTechnical HonorsGeneralCert. of CompletionHiddenIEP : Yes No Hidden504 : Yes No HiddenSAC/AtoE : Yes No HiddenIvy Tech Community College C number if applicable : HiddenPassed English GQE : Yes No HiddenPassed Algebra GQE : Yes No HiddenIs This Class Being Audited? : Yes No HiddenIf Yes : Semester 1 or Semester 2 or Both HiddenDiscipline Concerns (if any) :HiddenComments :HiddenCounselor’s Signature :HiddenDate:* HiddenSECTION FIVE - BRCPHiddenBRCP Director: Approved : Yes No HiddenDirector’s Signature : HiddenDate : HiddenComments :
Blue River Career Programs
Blue River Career Programs