Concord Regional Technical Center

If you would like to learn more about CRTC, please complete this form. By doing so, you will be kept up to date regarding upcoming events, application deadlines, and other opportunities at CRTC. ****Please note, this is NOT the CRTC application. That is a different form.

About the Student

One piece of information in each block section. Put your information in the block above the words.

Name

First

Middle

Last

Preferred Name

Gender

Date of Birth

mm/dd/yyyy

Applying to CRTC for what Grade

For the Fall of

Current School

Student School Email

Student Personal Email

Hometown

Program Interests

Select your program(s) of interest.

First Choice

Second Choice

Third Choice

Future CRTC Planning

CRTC is exploring the addition of a new CRTC program for the next school year and are gathering student input to help guide our planning. This programs is currently pending approval:

Welding:

In welding, students will earn safety, basic metalworking, and hands-on skills in common processes such as MIG, TIG, and Stick welding while building the foundational skills needed for future training and careers in the welding industry.

If offered, would this be your first choice CTE program?

Yes No

Your feedback is important and will help us determine whether this program will move forward. Thank you for taking a moment to share your interests!

If there is a program that you are interested in, but do not see above, please list here.

About Your Parent/Guardian

Name

First

Middle

Last

Suffix

Preferred Name

Relationship to Student

Parent 1 phone (xxx-xxx-xxxx)

Type

Number

Parent 2 phone (xxx-xxx-xxxx)

Type

Number

Parent Email

Parent Mailing Address

Thank you for reaching out to us! Just out of curiosity...

How did you hear about Concord Regional Technical Center? (check all that apply)

Please specify