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Clarion County Career Center
(814) 226-4391
447 Career Lane Shippenville PA 16254
Thank You! Your Application has been received!
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Choose your Program - 2nd Choice
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Allied Health Science
Automotive Technology
Construction Technology
Computer Networking
Cosmetology Styling Academy
Culinary Arts & Hospitality
Diesel Technology
Police Science
Welding & Fabrication
Choose your Program - 1st Choice
*
Allied Health Science
Automotive Technology
Construction Technology
Computer Networking
Cosmetology Styling Academy
Culinary Arts & Hospitality
Diesel Technology
Police Science
Welding & Fabrication
If Multiracial was Chosen, Please Choose Two:
American Indian/Alaska Native
Asian
Black/African American
Hawaiian/Pacific Islander
White
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Students email address
Graduation Year
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State of Birth
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Today's Date
Gender
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Phone
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City of Birth
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Birth Date (MM/DD/YYYY)
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Race: Please Choose One
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American Indian/Alaska Native
Asian
Black/African American
Hawaiian/Pacific Islander
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Multiracial
Name of person(s) that student lives with
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Student Signature
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Students Full Name
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Relationship to student
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School District
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PHYSICAL Address (Street/City/State/Zip)
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MAILING Address (Street/City/State/Zip)
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Race: Hispanic
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COUNTRY of Birth
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