STUDENT APPLICATION ESSEX COUNTY VOCATIONAL …

STUDENT APPLICATION ESSEX COUNTY VOCATIONAL TECHNICAL SCHOOLS

APPLICANT INFORMATION

To be completed by Applicant and Parent/Guardian

APPLICATION FOR: ____ SHARED-TIME (W. Caldwell only) ___ FULL TIME ENTERING GRADE ___ 9 ___ 10

__________________________ _____________________ _______________

Applicant's Last Name

First Name

M.I.

_____________________________ Date of Birth

_________________________________________ ________ ____________________________ _____________________

Address

Apt. #

City

Zip Code

_____________________________________________ ________________________________________________________

School Presently Attending

School Address

Student NJ State (SMART) ID # ____________________ Parent's e-mail address _______________________

(These questions are optional and are used for State reporting) Please check all that apply: ___ Male ___ Female ___ Caucasian ___ African American ___ Hispanic ___ Asian/Pacific Islander ___ American Indian ___ Other _________________________

What language is spoken most often at home? ______________________________________________

PARENT/GUARDIAN INFORMATION

_________________________________________ ________________________________ ____________________

Father's/Guardian's Last Name

First Name

M.I.

_________________________________________ ______________________________________________________

Home Phone

Cell Number

________________________________ ____________________________ ________________ __________________

Place of Employment/Dept.

Address

City

Telephone

_________________________________________ _________________________________ ___________________

Mother's/Guardian's Last Name

First Name

M.I.

_________________________________________ _______________________________________________________

Home Phone if Different from Father

Cell Number

________________________________ ____________________________ ________________ ___________________

Place of Employment/Dept.

Address

City

Telephone

Emergency Contact: Name ___________________________ Relationship ________________Tel. Number ____________

Parent/Guardian Signature

I hereby authorize and request that my child's school release all appropriate school records (transcripts and/or progress reports, attendance records, standardized test scores, discipline records, etc.) to the Essex County Vocational Technical High School District.

_____ Please check here if you wish to voluntarily provide ESL, Health Records, IEP status or Child Study Team reports with your initial application. _____ Please check if in agreement: Student interviews, photographs and video clips may be included in district publications, the district website and released for publicity purposes.

___________________________________________________

_______________________

Parent/Guardian SignaStuTreUDENT APPLICATION

Date

Parent/Guardian e-mail addrEesSsS_E__X__C__O__U__N_T__Y__V__O__C__A_T__I_O__N__A_L__S__C__H_O__O__L__S__________________

PLEASE INDICATE SCHOOL YOU WOULD LIKE TO ATTEND IN ORDER OF PERFERENCE PLEASE SUBMIT APPLICATION TO YOUR NUMBER ONE (1) CHOICE

Bloomfield Tech Campus ___ 209 Franklin Street, Bloomfield, NJ 07003

North 13th Street Tech Campus ___ 300 North 13th Street, Newark, NJ 07107

Newark Tech Campus ___ 91 West Market Street, Newark, NJ 07103

West Caldwell Tech Campus ___ 620 Passaic Avenue, West Caldwell, NJ 07006

Are you interested in enrolling in a shared time program? ___ Yes ___ No

Listed below are E.C.V.T.S. Campus locations with their respective Career & Technical Education offerings

NEWARK TECH CAMPUS

NORTH 13TH STREET TECH CAMPUS

ARTS, AUDIO-VISUAL,TECHNOLOGY & COMMUNICATION ? Music Technology

BUSINESS MANAGEMENT & ADMINISTRATION ? Entrepreneurship ? Marketing

FINANCE ? Accounting

HEALTH SCIENCE ? Dental Assistant ? Nursing Assistant & Patient Care

INFORMATION SYSTEMS ? Telecommunications/Home Entertainment Line Installers ? CISCO Certifications

MANUFACTURING ? Cabinet/Millwright ? Welding

SCIENCE, TECHNOLOGY, ENGINEERING & MATH (STEM) ? Engineering Technology ? Robotics Technology

TRANSPORTATION, DISTRIBUTION &LOGISTICS ? Automotive Technology

ARCHITECTURE AND CONSTRUCTION ? Construction Technology ? Building Trades Technology

ARTS, AUDIO-VISUAL TECHNOLOGY & COMMUNICATIONS ? Technical Theater ? Theater Design & Technology

BUSINESS MANAGEMENT & ADMINISTRATION ? Entrepreneurship ? Marketing

FINANCE ? Accounting

INFORMATION SYSTEMS ? Telecommunications/Home Entertainment Line Installers ? Web Design/Multi Media

HOSPITALITY & TOURISM ? Culinary Arts/ Food Science (ADD)

HUMAN SERVICES ? Cosmetology

LAW & PUBLIC SAFETY ? Criminal Justice/Law Enforcement ? Legal Studies/Law ? Forensic Science

BLOOMFIELD TECH CAMPUS

ARCHITECTURE AND CONSTRUCTION ** ? Architectural Drafting/CAD ? Carpentry/Carpenter ? Electrical/Electrician ? Heating, Ventilation, Air Conditioning (HVAC) ? Plumbing/Plumber

ARTS, AUDIO-VISUAL TECHNOLOGY & COMMUNICATIONS ? Commercial & Advertising Art ? Multimedia Graphic Design ? Printing Management ? Radio & TV Broadcasting Technology

BUSINESS MANAGEMENT & ADMINISTRATION ? Entrepreneurship ? Marketing

EDUCATION Education

FINANCE ? Accounting

SCIENCE, TECHNOLOGY, ENGINEERING & MATH (STEM) ? Engineering Technology (Green Energy Academy)

WEST CALDWELL TECH CAMPUS

AGRICULTURE, FOOD & NATURAL RESOURCES ? Animal Science & Plant Science

ARCHITECTURE AND CONSTRUCTION ? Construction Technology ? Building Trades Technology *

ARTS, AUDIO-VISUAL TECHNOLOGY & COMMUNICATIONS ? Commercial & Advertising Art ? Music Technology ? Culinary Arts *

HUMAN SERVICES * ? Cosmetology

INFORMATION SYSTEMS Computer Programming (ADD)

MARKETING ? Special Products Retail Marketing

TRANSPORTATION, DISTRIBUTION &LOGISTICS* ? Automotive Technology *

* Also offered as a shared-time Career & Technical Education Program

** All courses support Green Energy

To be completed by Applicant.

Applicant Essay

Name _________________________________________ Current School _____________________________ Please print

Essay Topic: Why I would like to attend Essex County Vocational Technical Schools.

__________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

FOR OFFICAL USE ONLY Date Received ________________________________ Interview Date ________________________________

Accuplacer Test Date____________________ Accuplacer Test Scores - L.A.______________

Math ____________

STATEMENT OF NON-DISCRIMINATION

State and federal statutes and regulations prohibit school districts from discriminatory practices in employment or vocational educational opportunities against any person by reason of race, color, creed, religion, sex, ancestry, national origin, age, English proficiency, sexual preference, marital status or veteran status. Further, state and federal protection is extended on account of disabilities, social or economic status, pregnancy, childbirth, pregnancy related disabilities, actual or potential parenthood, or family status and other applicable laws. Further information regarding these policies can be obtained from the 504 Compliance Officer, Dr. Michael Zelkowitz (973-412-2050, ext.2220) or Affirmative Action Officer, Ms. Cathleen Smith (ext. 4303)

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