OTC+ School Counselor Form

OTC+ School Counselor Form

Please complete this form to ensure your student and their parent/guardian understands the enrollment process and expectations for enrollment in the OTC+ classes available to high school seniors.
Student Information
Student's full name

First NameLast Name
Student SSID number
High school student is attending
Student email
example@example.com
EMIS Required Reporting
Enrollment Type: EMIS reporting question - How received
English Learner (EL) Status
OTC+ Program Applying For
Full-time programs enroll high school students only and run during the school day.

Short-term programs enroll adults and high school students and run during the evening.
Full-Time Day Programs:
Short Term Evening Programs:
School Counselor Information
School Counselor Name

First NameLast Name
School Counselor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
School Counselor Email
example@example.com
Student is on track for graduation. If "No", please explain below
If the answer above is "No", please explain:
Counselor Notes:
Please attach the student's current transcript

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I, the undersigned school counselor, hereby give my consent for the student to enroll in an OTC+ class with Knox Technical Center. I have discussed the adult education requirements, expectations, and schedule with both the student and their parent/guardian.
School counselor signature
Date

MonthDayYear
Date
Should be Empty:

Student Information