ENROLLMENT APPLICATION

This form is different than the K12 form you completed to be added to to this class.

This form includes Student and Employment information and is one of your required forms to earn a passing grade.

Click NEXT to complete the form

Student Information
First Name*
Middle Name
Student Last Name*
MHHS ID #*
Grade*
Date of Birth*

MonthDayYear
Date
MaleFemaleOther
Home Mailing Address*
City*
Zip*
Telephone*
Student phone number
Palomar I.D. Number*
SMUSD Email Address*
E-mail Address (one you check REGULARLY)*
This email address will be used for all Work Experience correspondence.
Parent/Guardian E-mail Address*

Educational & Career Information
What are your plans after high school?
College Major
What major are you planning to declare?
Which branch?
What type of Apprenticeship?
Occupational Goal: What career field are you thinking of going into?
Job Related Class (if applicable)
Are you taking any classes related to this career field
Number of Work Experience/Internship units your are enrolled:*

3 Palomar College Units & 5 High School elective credits
Occupational Work Experience Education
Student Acknowledgment of required Employment/ Internship Hours: For Each unit of enrollment, the student MUST complete a minimum of 54 hours (total 162) to receive a passing grade.
Student Signature (hand written or digital signature acceptable)*

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Date*

MonthDayYear
Date
Date*

MonthDayYear
Date
Instructor Name
Palomar College Instructors Name

The forms of communication for this class are:
- In-person & virtual office hours
- REMIND (text messages)
- Email (personal and school)
Since this class is not a face to face class, it is very easy to forget about it.
Acknowledgement : I am aware of the various ways to communicate with Mrs. Montooth if I have any questions or concerns regarding my success in this class.
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Student Information