To Be Completed By ICTC Staff · Processing of materials into intermediate or final products and...
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240 CareerTech Way, Tahlequah, OK 74464 P: 918-456-2595 F: 888-813-8359 www.ictctech.com Date of Application: _____________ (Please print clearly when completing application) Name:____________________________________________________________________________________ (First) (MI) (Last) Mailing Address:____________________________________________________________________________ (Address) (City) (State) (Zip) Home Phone:_____________ Cell Phone: ____________ Email:____________________________________ Emergency Contact: ___________________________________________________________ (Name) (Relation) (Phone) (If selected as an ICTC student, please circle your t-shirt size) S M L XL 2XL 3XL 4XL STUDENT INFORMATION RELEASE APPROVAL: This is an authorization for the local school district to release to Indian Capital the student records, including confidential records, concerning my son/daughter as they relate to determining appropriate enrollment. I hereby give approval to have my son/daughter attend ICTC once placement is determined. ________________________________________________ ______________ ______________________________________________ _____________ Signature of parent/guardian Date Signature of applicant Date To Be Completed By High School Students Only Name of High School: __________________________ Current Grade Level:_____ Date of Birth:_________ Father/Guardian:_______________________________________________________________ (First Name) (Last Name) (Place of Employment) ___________________________________________________________________________ (Home Phone) (Cell Phone) (Work Phone) (E-Mail Address) Mother/Guardian: ______________________________________________________________ (First Name) (Last Name) (Place of Employment) ___________________________________________________________________________ (Home Phone) (Cell Phone) (Work Phone) (E-Mail Address) To Be Completed By Adult Students Only Are you seeking financial aid? No Yes If you are seeking financial aid from any of the agencies such as WIA, TANF, VA, BIA, or Voc-Rehab, please list the agency and the counselor’s name: _____________________________________ Do you have a High School diploma? No Yes Do you have a GED? No Yes year_______________ Do you have educational records under any other name (i.e. maiden name)? No Yes If yes, what name: ___________________________________________________ List other schools attended: __________________________________________ ___________ (School) (Year) Have you ever attended ICTC as a post-secondary day student? No Yes year ________ Miscellaneous: Have you ever been convicted of a felony? Yes ______ No _______ If yes, what state(s) _________________________________________________________________________ Have you ever been dismissed from another educational institution for disciplinary action? Yes _____ No ______ ** A felony conviction does not necessarily eliminate you from selection or from successfully finding a job after completion. However, failure to provide honest and accurate information on the application will result in dismissal from the application process or school if you have been admitted. ** To Be Completed By ICTC Staff _____________________________________________________ _________________________________ 9 10 11 12 Adult Career Major:_______________________________ AM PM Full Time Last Name First Name Home School (At time of entry) GPA:___________ Pre-ACT: _____________ Senior Scholarship GED/Diploma Transcript Assessment Results Total Score:___________ Start Date: _____________ Financial Aid Acceptance Notification Entered into System Daytime Application 2017-2018 TAHLEQUAH CAMPUS
Transcript of To Be Completed By ICTC Staff · Processing of materials into intermediate or final products and...
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240 CareerTech Way, Tahlequah, OK 74464 P: 918-456-2595 F: 888-813-8359 www.ictctech.com www.ictctech.com
Date of Application: _____________ (Please print clearly when completing application)
Name:____________________________________________________________________________________ (First) (MI) (Last)
Mailing Address:____________________________________________________________________________ (Address) (City) (State) (Zip)
Home Phone:_____________ Cell Phone: ____________ Email:____________________________________
Emergency Contact: ___________________________________________________________ (Name) (Relation) (Phone) (If selected as an ICTC student, please circle your t-shirt size) S M L XL 2XL 3XL 4XL
STUDENT INFORMATION RELEASE APPROVAL: This is an authorization for the local school district to release to Indian Capital the student records, including confidential records, concerning my son/daughter as they relate to determining appropriate enrollment. I hereby give approval to have my son/daughter attend ICTC once placement is determined. ________________________________________________ ______________ ______________________________________________ _____________
Signature of parent/guardian Date Signature of applicant Date
To Be Completed By High School Students Only Name of High School: __________________________ Current Grade Level:_____ Date of Birth:_________
Father/Guardian:_______________________________________________________________ (First Name) (Last Name) (Place of Employment)
___________________________________________________________________________ (Home Phone) (Cell Phone) (Work Phone) (E-Mail Address)
Mother/Guardian: ______________________________________________________________ (First Name) (Last Name) (Place of Employment)
___________________________________________________________________________ (Home Phone) (Cell Phone) (Work Phone) (E-Mail Address)
To Be Completed By Adult Students Only Are you seeking financial aid? No Yes If you are seeking financial aid from any of the agencies such as WIA, TANF, VA, BIA, or Voc-Rehab, please list the agency and the counselor’s name: _____________________________________ Do you have a High School diploma? No Yes Do you have a GED? No Yes year_______________
Do you have educational records under any other name (i.e. maiden name)? No Yes If yes, what name: ___________________________________________________
List other schools attended: __________________________________________ ___________ (School) (Year)
Have you ever attended ICTC as a post-secondary day student? No Yes year ________
Miscellaneous: Have you ever been convicted of a felony? Yes ______ No _______
If yes, what state(s) _________________________________________________________________________
Have you ever been dismissed from another educational institution for disciplinary action? Yes _____ No ______
** A felony conviction does not necessarily eliminate you from selection or from successfully finding a job after completion. However, failure to provide honest and accurate information on the application will result in dismissal from the application process or school if you have been admitted. **
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Daytime Application 2017-2018 TAHLEQUAH
CAMPUS
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Choose a Career Major from the following options:
I am interested in the following career major and would like to discuss it with an ICTC counselor: 1st Choice _______________________________________ 2nd Choice ____________________________________
I prefer to attend: _____AM (8:00 – 11:00) _____PM (12:00 – 3:00) _____Both (8:00 – 3:00) Adult only Which of the following influenced your decision to attend ICTC? Tech Fest Friend Relative Counselor ICTC Catalog ICTC Website Newspaper Advertisement Other (please specify) _____________________
Notice: Completion of this application by itself does not constitute admission to Indian Capital Technology Center. Please attach the following information to this application for it to be considered complete.
High School Checklist Adult Checklist High School Transcript Transcript/GED Attendance Record Keytrain Results Pre-ACT Test Result Interest Inventory Interest Inventory (Contact ICTC for testing schedule)
An interview to discuss placement will be scheduled upon receipt of the application. Adults Only: After placement in an ICTC career major: If you have disabilities which require reasonable accommodations to perform the essential skills of the career major, it is your responsibility to provide documentation and to notify your instructor or the student services coordinator. Non-Discrimination Statement: Indian Capital Technology Center is an equal opportunity institution in accordance with civil rights legislation and does not discriminate on the basis of race, color, religion, national origin, sex/gender, age, marital or veteran status, or disability in the operation of its educational programs, activities, recruitment and admission practices. Concerns regarding this policy should be addressed to Sharon Billings, District Compliance Coordinator, at 918-687-6383 or 1-800-375-8324, 2403 N. 41st Street E, Muskogee, OK 74403. Additionally, each campus has a contact in which complaints can be reported.
240 CareerTech Way, Tahlequah, OK 74464 P: 918-456-2594 F: 888-813-8359 www.ictctech.com
Auto Collision Repair Collision Repair Technician
Auto Service Technology Automotive Service Technician (NATEF Compliant)
Business, Management & Administration Administrative Assistant Legal Office Assistant Medical Office Assistant
Carpentry Residential/Commercial Carpenter
Criminal Justice Criminal Justice Practitioner
Health Careers Certification Long Term Care/Home Health Care Assistant (HS only)
Heating, Ventilation, & Air Conditioning Residential HVAC Technician
Heavy Equipment Heavy Equipment Operator I
Information Technology Enterprise Network Associate Cisco Network Associate Home Technology Integrator Network Management & Support
Service Careers Landscape Design/Lawn & Maintenance
Welding Combination Welder
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NAME _______________________________________________________
SCHOOL _____________________________________________________
DATE ________________________________________________________
CAREER CLUSTERS INTEREST SURVEY Circle the items in each box that best describe you. You may make as many or as few circles in each box you choose. Add up the number of circles in each box. Look to see which three boxes have the highest number.
BO
X 1
Activities that describe what I like to do:
Learn how things grow and stay alive. Make the best use of the earth’s natural resources. Hunt and/or fish. Protect the environment. Be outdoors in all kinds of weather. Plan, budget, and keep records. Operate machines and keep them in good repair.
Personal qualities that describe me:
Self-reliant Nature lover Physically active Planner Creative problem solver
School subject that I like:
Math
Life Science
Earth Sciences
Chemistry
Agriculture
Total number circled in
Box 1
BO
X 2
Activities that describe what I like to do:
Read and follow blueprints and/or instructions. Picture in my mind what a finished product looks like. Work with my hands. Perform work that requires precise results. Solve technical problems. Visit and learn from beautiful, historic, or interesting
buildings. Follow logical, step-by-step procedures.
Personal qualities that describe me:
Curious
Good at following directions
Pay attention to detail
Good at visualizing
Patient and persistent
School subject that I like:
Math Drafting Physical Sciences Construction Trades Electrical Trades/Heat, A/C & Refrigeration/
Technology Education
1. 2.
Total number circled in
Box 2
BO
X 3
Activities that describe what I like to do:
Perform routine, organized activities but can be flexible. Work with numbers and detailed information. Be the leader in a group. Make business contact with people. Work with computer programs. Create reports and communicate ideas. Plan my work and follow instructions without close
supervision.
Personal qualities that describe me:
Compassionate and caring Good at following directions Conscientious and careful Patient Good listener
School subject that I like:
Computer Applications/Business and Information Technology
Accounting Math English Economics
Total number circled in
Box 3
BO
X 4
Activities that describe what I like to do:
Work under pressure.
Help sick people and animals.
Make decisions based on logic and information.
Participate in health and science classes.
Respond quickly and calmly in emergencies.
Work as a member of a team.
Follow guidelines precisely and meet strict standards of
accuracy.
Personal qualities that describe me:
Compassionate and caring
Good at following directions
Conscientious and careful
Patient
Good listener
School subject that I like:
Biological Sciences Chemistry
Math
Language Arts Occupational Health
Classes
Total number circled in
Box 4
BO
X 5
Activities that describe what I like to do:
Work with computers.
Reason clearly and logically to solve complex problems.
Use machines, techniques, and processes.
Read technical materials and diagrams and solve technical problems.
Adapt to change.
Play video games and figure out how they work.
Concentrate for long periods without being distracted.
Personal qualities that describe me:
Logical/analytical thinker
Sees detail in the big picture
Persistent
Good concentration skills
Precise and accurate
School subject that I like:
Math
Science
Computer Tech/ Applications
Communications Graphic Design
Total number circled in
Box 5
BO
X 6
Activities that describe what I like to do:
Work with hands and learn best that way.
Put things together.
Do routine, organized and accurate work.
Perform activities that produce tangible results.
Apply math to work out solutions.
Use hand and power tools and operate equipment/machinery.
Personal qualities that describe me:
Practical
Observant
Physically active
Step-by-step thinker
Coordinated
School subject that I like:
Math-Geometry
Chemistry
Trade and Industry courses
Physics
Language Arts
Total number circled in
Box 6
(Turn over to complete back)
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Identify the boxes with the three highest numbers and list them in order on the lines below:
1st Highest______________ 2nd Highest ______________ 3rd Highest ______________
Locate the cluster(s) below that relate to your three highest boxes. Circle the ICTC Career Major you are most interested in learning more about.
Cluster Description ICTC Career Major(s) BOX 1
AGRICULTURE, FOOD & NATURAL RESOURCES
The production, processing, marketing, distribution, financing, and development of agricultural commodities and resources including food, fiber, wood products, natural resources, horticulture, and other plant and animal products/resources.
* Service Careers
BOX 2
ARCHITECTURE & CONSTRUCTION
Careers in designing, planning, managing, building, and maintaining the built environment.
*Residential/Commercial Carpenter *Residential HVAC Technician *Heavy Equipment Operator I
BOX 3
BUSINESS, MANAGEMENT & ADMINISTRATION
Careers that encompass planning, organizing, directing and evaluating business function essential to efficient and productive business operations.
*Administrative Assistant *Medical Office Assistant *Legal Office Assistant
BOX 4
HEALTH SCIENCE Occupations that require planning, managing, and providing therapeutic services, diagnostic services, health informatics, support services, and biotechnology research and development.
*LongTerm Care/Home Health Care Assistant (HS Only) **Practical Nursing (Adult Only)
BOX 5
INFORMATION TECHNOLOGY
Building linkages in IT occupations framework for entry-level, technical, and professional careers related to the design, development, support and management of hardware, software, multimedia, and systems integration services.
*Enterprise Network Associate *CISCO Network Associate *Home Technology Integrator *Network Management & Support
BOX 6
MANUFACTURING Processing of materials into intermediate or final products and related professional and technical support activities such as production planning and control, maintenance, and manufacturing/process engineering.
*Combination Welder
BOX 7
TRANSPORTATION, DISTRIBUTION & LOGISTICS
Planning, management, and movement of people, materials, and goods by road, pipeline, air, rail, and water and related professional and technical support services.
*Auto Service Technician (NATEF Compliant) *Collision Repair Technician
BOX 8
LAW, PUBLIC SAFETY, CORRECTIONS &SECURITY
Planning, managing, and providing legal, public safety, protective services and homeland security, including professional and technical support services.
*Criminal Justice Practitioner
Note: Your interests may change from time-to-time. These survey results are intended to help you with informal career exploration for the career majors that are offered at our school. It does not make any claims of statistical reliability.
For more information, check with a career counselor at your high school, Career Tech Center, higher education institution, or one-stop career centers.
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OX
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Activities that describe what I like to do:
Travel
See well and have quick reflexes.
Solve mechanical problems.
Design efficient processes.
Anticipate needs and prepare to meet them.
Move things one place to another.
Personal qualities that describe me:
Realistic
Mechanical
Coordinated
Observant
Planner
School subject that I like:
Math
Economics
Trade and Industry courses
Physical Sciences
Foreign Language
Total number circled in
Box 7
BO
X 8
Activities that describe what I like to do:
Work under pressure or in the face of danger.
Make decisions based on my own observations.
Interact with other people.
Be in positions of authority.
Respect rules and regulations.
Debate and win arguments.
Observe and analyze people’s behavior.
Personal qualities that describe me:
Adventurous
Dependable
Community-minded
Decisive
Optimistic
School subject that I like:
Language Arts
Psychology/Sociology
Government/History
Law Enforcement
First Aid/First Responder
Total number circled in
Box 8
Indian Capital Technology Center does not discriminate on the basis of race, color, religion, national origin, sex/gender, age, disability, marital or veteran status.
