ASCEND Application Form
Name:
*
Last Name
First Name
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number:
-
Area Code
Phone Number
Cell Phone Number:
-
Area Code
Phone Number
E-mail:
*
Date of Birth (mm/dd/yy)
*
Gender:
*
Female
Male
Grade Level:
*
Please Select
9th Grade (Freshman)
10th Grade (Sophomore)
11th Grade (Junior)
12th Grade (Senior)
High School Name:
*
High School Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Weighted GPA:
*
Unweighted GPA:
*
Career Interests (check all that apply):
*
Agriculture, Food & Natural Resources
Architecture & Construction
Arts
Audio/Visual Technology
Business
Communications
Education & Training
Finance Planning
Government & Public Administration Planning
Health Science (Medicine, Dentistry, Nursing, Pharmacy)
Human Services (e.g. Social Work, Counseling)
Information Technology
Law, Public Safety, Corrections & Security
Management & Administration
Manufacturing
Marketing
Military Services (e.g., Army, Navy, Marines, Reserves)
Science, Technology, Engineering & Math (STEM)
Transportation, Distribution & Logistics
Vocational Trade (e.g. Automotive, Construction, Industrial, Technician)
Other
Signed Student Code of Conduct & Responsibility Contract:
*
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Signed Parental Consent & Responsibility Form:
*
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School Transcript with Registrar Seal:
*
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Letter of Recommendation:
*
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Essay:
*
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T-Shirt Size:
*
Please Select
XS
S
M
L
XL
2XL
3XL
Food Allergies:
Parent/Legal Guardian Information
Name:
*
Last Name
First Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number:
-
Area Code
Phone Number
Cell Phone Number:
*
-
Area Code
Phone Number
E-mail:
*
Emergency Contacts
Name:
Last Name
First Name
Name:
Last Name
First Name
Phone Number
-
Area Code
Phone Number
Phone Number
-
Area Code
Phone Number
E-mail
E-mail
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