Student Application
Student Name*
Student ID
Gender
Female
Male
Other
Date of Birth
(mm/dd/yyyy)
High School*
Highline
Tyee
Evergreen
Mount Rainier
PSSC
Other
Please specify
Email Field*
Home Phone
Enter without hyphens: 2066313000 (do not include a '1' before the area code)
Cell Phone
Enter without hyphens: 2066313000 (do not include a '1' before the area code)
Home Address*
City
State
Zip
(ex. 06108 or 06108-0809)
Parent / Guardian Daytime Phone
Enter without hyphens: 2066313000 (do not include a '1' before the area code)
Work Site
Job Title
Describe your duties
Career Plans and Goals
Career Plans / Goals
Arts & Communication
Business & Marketing
Health and Human Services
Science & Agriculture
Technology & Engineering
Other
Please specify
Career Goal
Intended post-secondary training/education program
O.J.T
Apprenticeship
Technical School
2-year College
4-year University
Military / Volunteer Program
Other
Please specify
Where do you plan to pursue your post-secondary training/education?
If undecided, please write "undecided"