2024- 2025 Buckeye Career Center Student Application
Junior and senior level high school programs
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Email *
Last Name *
First Name *
Middle Name
District of Residence *
School District of Enrollment *
Address
City
State
Zip Code
Mailing address (if different from above)
1st Choice Program *
2nd Choice Program *
Birthdate *
MM
/
DD
/
YYYY
Birth City
County of Residence
Gender
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Grade for the 24-25 School Year
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Applicant's Guardian
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Applicant Lives with
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Parent/Guardian (1) Last Name
Parent/Guardian (1) First Name
Parent/Guardian (1) Address
Parent/Guardian (1) Phone Number
Parent/Guardian (1) Place of Employment
Parent/Guardian (1) Work Phone Number
Parent/Guardian (2) Last Name
Parent/Guardian (2) First Name
Parent/Guardian (2) Address
Parent/Guardian (2) Phone Number
Parent/Guardian (2) Place of Employment
Parent/Guardian (2) Work Phone Number
Parent/Guardian email address for official school notifications
Parent/Guardian cell phone number for official school notifications by text
Applicant's Signature: I understand the program for which I have applied and have discussed my selection with my parent/guardian. Please type your name below. *
Parent/Guardian Signature on this application authorizes Buckeye Career Center to receive all educational records from the student's high school, i.e. transcripts, IEP, and standardized tests. The district will not disclose this information. Parent/guardian agrees to provide work attire and pay fees as required. *
If parents/guardians are divorced/separated, do court documents limit contact with the applicant?
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If yes, A copy of these documents must be provided to the BCC Guidance Office before the start of the school year. Attn: Principal 545 University Dr. NE New Philadelphia, OH 44663  330.339.2288  1-800-227-1665
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