Wellington-Napoleon Tech Center Application
Please fill out and make sure you pick your top 2 program choices. Our priority deadline is January 31, 2025.
Sign in to Google to save your progress. Learn more
Last Name *
First Name *
Middle Name *
What High School do you attend? *
1st Choice Program. *
2nd Choice Program. *
Home Address *
City *
Zip Code *
Gender *
Ethnicity  *
Name of the parent(s) / guardian(s) you live with. *
Student Cell/Home Phone Number 
Example: 6602591234
 *
Student Email Address *
Current Grade Level *
PARENT/LEGAL GUARDIANS
Please complete the following questions with information on your parent or legal guardian.
First Parent/Guardian (First and Last Name) *
Relationship to student *
Address if different from student.
First Parent/Guardian Phone Number  *
First Parent/Guardian Email Address *
Place of Employment
Occupation.
Second Parent/Guardian (First and Last Name)
Relationship to student
Clear selection
Address if different from student.
Second Parent/Guardian Phone Number
Second Parent/Guardian Email Address
Place of Employment.
Occupation.
Emergency contact. Please list name,  phone number and relationship to student *
Emergency contact. Please list name,  phone number and relationship to student *
Individuals allowed to pick student up for Lex La-Ray. Please list name and relationship to student. *
ESSAY QUESTIONS
Answer in paragraph form.
Explain why you believe you are a good candidate for your 1st choice of program at Lex La-Ray?  *
Why are you interested in enrolling in your 2nd choice of program?
Describe what you know about careers related to these programs and how it might help you reach your educational and career goals. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Lexington R-V School District.

Does this form look suspicious? Report

Google Forms