2023-2024 First Year High School Student Application

2023-2024 First Year High School Student Application

This application is for students who are NOT CURRENTLY enrolled in an SCCC program. This information will be sent to your counselor and principal for approval.
Student Legal Name*

First NameMiddle NameLast NameSuffix
Student Current Grade Level:*

1110
Anticipated Year of Graduation*
What high school do you attend?*
FIRST CHOICE PROGRAM-What SCCC program/class are you wanting to attend?*
Please note that any health science program (including Health Science II/CNA and Pharmacy Tech) requires student drug testing. Also, a separate application is available for the new high school practical nursing program.
ALTERNATE PROGRAM-If your first choice is not available, what other program would you like to attend?*
Please note that any health science program (including Health Science II/CNA and Pharmacy Tech) requires student drug testing.
Statement of Purpose: Briefly explain why you wish to enroll in a program at SCCC.*
Use complete sentences and include what your plans are after graduation. It will not be graded for anything, but is just a way for us to get to know you better.
Student Email Address*
example@example.com
Student Phone Number*
Please enter a valid phone number.
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Student County *
(Ex. Howell, Oregon, Ozark, Shannon, Texas, etc.)
Student Date of Birth*

MonthDayYear
Date
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number*
Please enter a valid phone number.
Student Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: