JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Ben Franklin Career Center Application
Application for High School Programs
Sign in to Google
to save your progress.
Learn more
Student Last Name
Your answer
Student First Name
Your answer
Current Grade
9
10
11
12
Clear selection
Student WVEIS (lunch) Number
Your answer
Student Phone Number
Your answer
Student Email
Your answer
Parent/Guardian Name
Your answer
Parent/Guardian Phone Number
Your answer
Home High School
Choose
Nitro High School
Sissonville High School
South Charleston High School
St. Albans High School
Capital High School
George Washington High School
Hoover High School
Riverside High School
Other
Program Choice #1
Animal Systems (1 yr program)
Auto Technology (2 yr program)
Carpentry (2 yr program)
Coding, Apps & Game Design (1 yr program)
Computer Systems Networking and Repair (1 yr program)
Diesel Equipment Technologies (2 yr program)
Early Childhood Education (1 yr program)
Electrical Technician
Health Occupations - Therapeutic Services (2 yr program) NOT OPEN to upcoming 10th grade students
HVAC Technician (2 yr program)
Law & Public Safety (1 yr program)
Manufacturing - 4T Academy (2 yr program)
Medical Assisting (2 yr program) NOT OPEN to upcoming 10th grade students
Medical Assisting Honors (2 yr program) NOT OPEN to upcoming 10th grade students
Metals Technology (1 yr program - open to 12th grade students only)
Metals & Machine Tool Technology (2 yr program)
Pet Grooming (1 yr program)
Pre-Nursing Honors (2 yr program) NOT OPEN to upcoming 10th grade students
Robotics (1 yr program)
Robotics (2 yr program)
Other:
Clear selection
Program Choice #2
Animal Systems (1 yr program)
Automotive Technology (2 yr program
Carpentry (2 yr program)
Coding, Apps & Game Design (1 yr program)
Computer Systems Networking and Repair (1 yr program)
Diesel Equipment Technologies (2 yr program)
Early Childhood Education (1 yr program)
Electrical Technician (2 yr program)
Health Occupations - Therapeutic Services (2 yr program) NOT OPEN for upcoming 10th graders
HVAC Technician (2 yr programs)
Law & Public Safety (1 yr program)
Manufacturing Technology - 4T Academy (2 yr program)
Medical Assisting (2 yr program) NOT OPEN to upcoming 10th grade students
Medical Assisting Honors (2 yr program) NOT OPEN to upcoming 10th grade students
Metals Technology (1 yr program - open to 12th grade students only)
Metals & Machine Tool Technology (2 yr program)
Pet Grooming (1 yr program)
Pre-Nursing Honors (2 yr program) NOT OPEN to upcoming 10th grade students
Robotics (1 yr program)
Robotics (2 yr program)
Other:
Clear selection
Program Choice #3
Animal Services (1 yr program)
Auto Technology (2 yr program)
Carpentry (2 yr program)
Coding, Apps & Game Design ( 1 yr program)
Computer Systems Networking and Repair (1 yr program)
Diesel Equipment Technologies (2 yr program)
Early Childhood Education (1 yr program)
Electrical Technician (2 yr program)
Health Occupations - Therapeutic Services (2 yr program) NOT OPEN to upcoming 10th graders
HVAC Technician (2 yr program)
Law & Public Safety (1 yr program)
Manufacturing - 4T Academy (2 yr program)
Medical Assisting (2 yr program) NOT OPEN to upcoming 10th grade students
Medical Assisting Honors (2 yr program) NOT OPEN to upcoming 10th grade students
Metals Technology (1 yr program - open to 12th grade students only)
Metals & Machine Tool Technology (2 yr program)
Pet Grooming (1 yr program)
Pre-Nursing Honors (2 yr program) NOT OPEN to upcoming 10th grade students
Robotics (1 yr program)
Robotics (2 yr program)
Other:
Clear selection
What is your reason for wanting to enroll in the programs you selected above?
Your answer
Name of Reference (someone not related to you)
Your answer
Phone Number of Reference
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Kanawha County Schools.
Report Abuse
Forms
