RETURNING STUDENT APPLICATION BLUE RIVER CAREER PROGRAMS RETURNING STUDENT APPLICATION 2023-2024 Step 1 of 2 50% SECTION ONEStudent Legal Name :* First Last Student Phone Number :*Student Email :* Date of Birth :* Gender :Select your sexFemaleMaleGraduation Year :*Choose your year202520262027Home School :*Select from listSHS – Shelbyville High SchoolTCHS – Triton Central High SchoolSWHS – Southwestern High SchoolMHS – Morristown Jr. Sr. High SchoolWHS – Waldron Jr. Sr. High SchoolMailing Address :* Street Address City ZIP Code Home Address (if different) : Street Address City ZIP Code Father Name :* First Last Phone Number :Email Address : Mother Name :* First Last Phone Number :Email Address : Guardian Name :* First Last Phone Number :Email Address : SECTION TWOChoose your first and second program choices.Current ProgramSelect your current programAuto Collision RepairAuto Services TechnologyConstruction TradesCriminal JusticeCulinary ArtsDiesel Service TechnologyFire & RescueHealth Sciences Yr. 1Health Sciences CapstoneHuman and Social ServicesWelding TechnologyWork Based Learning (Coop)First Choice ProgramSelect your first choiceAuto Collision RepairAutomotive ServicesConstruction TradesCriminal JusticeCulinary ArtsDiesel ServicesFire & Rescue yr. 1Fire & Rescue CapstoneEducation ProfessionsHealth Sciences yr. 1Health Sciences CapstoneHuman & Social ServicesWelding TechnologyWork Based LearningSecond Choice ProgramSelect your second choiceAuto Collision RepairAutomotive ServicesConstruction TradesCriminal JusticeCulinary ArtsDiesel ServicesFire & Rescue yr. 1Fire & Rescue CapstoneEducation ProfessionsHealth Sciences yr. 1Health Sciences CapstoneHuman & Social ServicesWelding TechnologyWork Based LearningFootnote Key : * Dual College Credit May Be Available ^ Criminal History Report Required ● Minimum Age Requirement (17 by May 2025) ♢ Seniors Only ∆ Minimum GPA 2.5 # Minimum Age Requirement (16 by May 2025) HiddenSECTION THREE - BRCP Student ServicesHiddenSTN : HiddenBRCP PS ID : Hidden1st 9wk BRCP grade : Hidden2nd 9wk BRCP grade : HiddenBRCP Credits earned : Hidden# of days absent 1st semester : HiddenUnex : HiddenEx. : HiddenDiscipline Concerns (if any) :HiddenComments :HiddenStudent Services Signature : HiddenDate : HiddenSECTION FOUR - Home School CounselorHiddenCurrent GPA : Hidden# of days absent year to date : HiddenCredits earned : HiddenSTN : Diploma Track :Sect your diploma trackCore 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 Not taken HiddenPassed Algebra GQE : Yes No Not taken 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