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Holland Medical High School Application for Admission 2021-2022
This application is for 10th and 11th graders currently enrolled in or who have already received credit for Principles of Health Science. Students should refer to the Holland Application Checklist while working through this form.
All sections must be completed and additional file uploaded to
jennifer.seekins@abileneisd.org
by March 4th, 2021. Incomplete or late submissions will not be considered.
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* Indicates required question
Email
*
Your email
Last Name
*
Your answer
First Name
*
Your answer
MI (middle initial)
Your answer
Gender
*
Male
Female
Prefer not to say
Student School ID #
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Your answer
Grade Level for 21-22
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11th
12th
Home Campus
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Abilene High
Cooper High
Do you participate in campus related activities which would cause you to need to be an AM or PM student? If so, which ones and when is this scheduled class? (examples: band, orchestra, choir, football, soccer, baseball, softball, etc)
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Your answer
Holland Program for which you are applying. (You must have complete CNA OR DHS to apply for Pharm, RDA or CCMA.) 1st Choice
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Choose
Certified Nurses Assistant
Diversified Healthcare SKills
Pharmacy Technician
Registered Dental Assistant
Certified Medical Assistant
Holland Program for which you are applying. (You must have complete CNA OR DHS to apply for Pharm, RDA or CCMA.) 2nd Choice
*
Choose
Certified Nurses Assistant
Diversified Healthcare SKills
Pharmacy Technician
Registered Dental Assistant
Certified Medical Assistant
Next
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