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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