2025-2026 YTC DE Application
(YTC Dual Enrollment Courses taught on CHS's Campus)
Name
*
First Name
Middle Name
Last Name
Suffix
Email
*
example@example.com
Address
*
Street Address
Mailing Address if different from Street Address
City
State / Province
Postal / Zip Code
Current Grade Level
*
10th
11th
Country of Birth
*
Have you been a legal South Carolina resident for more than one year?
yes
no
Father's Name
First Name
Last Name
Father's Email Address
example@example.com
Father's Cell Phone Number
-
Area Code
Phone Number
Father's Employer and Occupation
Mother's Name
First Name
Last Name
Mother's Email Address
example@example.com
Mother's Cell Phone Number
-
Area Code
Phone Number
Mother's Employer and Occupation
Emergency/Medical Information
*
Please list any medical conditions, medications or special accommodations.
Please select the YTC DE Program to which you are applying
*
Automotive Tech
CPT 236
Early Childhood
Health Science
By submitting this application, I attest that all of the information is true and I understand the level of commitment I will be making by taking these courses. Please electronically sign using your mouse.
Submit
Should be Empty: