PCCCC APPLICATION FOR NEW STUDENTS 2021-22

PICKENS COUNTY COLLEGE & CAREER CENTER

NEW STUDENT APPLICATION
Name *
High School *
Grade (next year) *
Address *
City *
State *
Zip *
Student Email *
example@example.com
Student Cell Phone *
Parent/Guardian Email *
example@example.com
Parent/Guardian Cell Phone *
Programs Offered
- Agriscience
- Computer Science (Dual Enrollment)
- Health Science
- Industrial Maintenance (Dual Enrollment)
- Modern Manufacturing (Dual Enrollment)
- Teacher Cadet
- Welding
PLEASE INDICATE IN WHICH PROGRAM YOU WISH TO ENROLL *
Teacher Signature *

Clear
Date *

Month Day Year
Date
Student Signature *

Clear
Date *

Month Day Year
Date
Parent Signature *

Clear
Date *

Month Day Year
Date
Non-Discrimination: The Pickens County School system offers Career and Technical education programs for all students regardless of race, color, national origin, gender,including those with limited English proficiency disability in its programs or activities and provides equal access to the Boy Scouts and other designated youth groups.
APPLICATION DEADLINE:

THURSDAY, MARCH 4TH
Should be Empty:

PICKENS COUNTY COLLEGE & CAREER CENTER