NEW STUDENT APPLICATION BLUE RIVER CAREER PROGRAMS NEW STUDENT APPLICATION 2021-2022 Blue River Career Programs Step 1 of 2 50% SECTION ONEStudent Legal Name :* First Last Student Phone Number :*Student Email :* Date of Birth :* Sex :FemaleMaleGrade Level 2021-22 Year :*Grade 9Grade 10Grade 11Grade 12Home School :*SHS – 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 : Phone Number :Email Address : Mother Name : Phone Number :Email Address : Guardian Name : 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.Auto Collision Repair*Auto Services Technology*Automation & Robotics ∆Construction Trades*Criminal Justice^Culinary Arts*Diesel Service Technology*Fire & Rescue*●Health Science Ed. I*Health Science Ed. II (CNA)*#Interactive Media*Welding Technology*Work Based Learning (Coop) ∆Second Choice ProgramPlease choose your first type of program from the dropdown menu.Auto Collision Repair*Auto Services Technology*Automation & Robotics ∆Construction Trades*Criminal Justice^Culinary Arts*Diesel Service Technology*Fire & Rescue*●Health Science Ed. I*Health Science Ed. II (CNA)*#Interactive Media*Welding Technology*Work Based Learning (Coop) ∆Footnote 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