Meceola Technical - Corrections

Application for Admission

Corrections Academy
Applicant Information
First Name*
Middle Initial
Last Name*
E-mail*
Phone Number*

Area CodePhone Number
Date of Birth*

MonthDayYear
NOTE - Social Security # will be required upon payment of deposit
Address*

Street Address

Street Address Line 2

CityState

Zip Code
How long have you lived at current address?*
Are you a citizen of the United States?*
Emergency Contact *

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number
Education
What is your highest level of education?*
Career Interest
Why are you interested in Technical Training?*

To obtain a job or careerTo learn additional skillsTo advance in my current companyTo receive additional certificationOther
What is your shirt size?*
Background Check Waiver / Signature
I understand that I may be required to undergo and pay for criminal and/or other background checks and drug testing in order to enter and participate in certain programs. I understand that any felony, misdemeanor, or recorded event may prevent me from entering or completing certain programs, degrees, or certificates; entering required clinical placements; or future employment, certification, or licensure. I understand and agree that background checks and drug testing reports that are done may be released to affiliated facilities participating with the technical school as part of my education.
Have you ever been convicted of a misdemeanor? (Other than a traffic violation)*
Have you ever been convicted of a felony?*
Do you have any criminal charges pending?*
By signing below you give the following permissions:

I give Meceola Tech my permission to obtain necessary background checks. I hereby affirm that the information included in this application is correct and true. I understand that any misrepresentation of this information will be cause for immediate disciplinary action which may include expulsion from the technical school.

***PHOTOGRAPHS & SOCIAL MEDIA***

Photographs are frequently taken of our students and at times they are used for newspaper articles about our programs and/or posted on our website or social media. If you DO NOT wish to have picture used in this manner, please give written notification to our office.

***Acknowledgment of Receipt of StudentPolicy and Procedure Handbook***

I acknowledge that I have received a personal copy of the Mecosta-Osceola Career CenterMeceola Tech StudentPolicy and Procedure Handbook. I will become familiar with this handbook and understand that I am expected to follow the rules and procedures contained within the Handbook.

***Acknowledgment of Policy No. 4510 Internet Acceptable Use Policy***

I acknowledge that I have received a personal copy the MOISD Policy Number 4510 (Internet Acceptable Use Policy). I have reviewed this policy with my child/parent(s)and. I understand I will be given a user name and password to use for educational purposes.
Signature*
How did you hear about Meceola Tech?*
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Application for Admission