Online Admissions Form

 
*Student First Name:
Middle Initial:
*Last Name:
*Grade:
Date of Birth
*Date of Birth Month:
*Day:
*Year:
*Address:
*City:
*State:
*Zip Code:
*Home Phone:
*Email:
*Home School:
Explain Other:
*Parent/Guardian Name:
*First Choice
Career/Technical Program:
*Applying for this Career/
Technical program because:
Second Choice
Career/Technical Program:
Applying for this Career/
Technical program because:
*Hobbies and/or
extracurricular activities:
Work Experience:
*MCCC T-Shirt Size (Select One):





I have discussed this application with my son or daughter and give my permission for the application to be processed.   

By submitting this application online, I grant permission to the Medina County Career Center Admission's team to access and review my son/daughter’s student records to facilitate appropriate placement in technical and academic classes.

  • RELEASE: The student records concerning my son/daughter may be transferred to the Medina County Career Center, JVSD from his/her affiliated school for review by the professional staff. The records will be used to determine whether Ohio state graduation requirements are fulfilled and to place students in appropriate classes.

  • The Medina County Career Center, JVSD has permission to reproduce, circulate, and publish photographs of the above student for school purposes.

  • Equal Opportunity: The Medina County Career Center, JVSD is committed to equal opportunity for all and does not discriminate on the basis of race, color, national origin, religion, sex, disability, or age in its programs and activities and provides equal access to the Boy Scouts and other designated youth groups.

*Parent/Guardians' Name:
*Parent/Guardians' Initials:

STOP - Please review all the fields prior to submitting your application.  It is very important we have the correct information on file for your student.  Please don't hesitate to contact the Admissions office for additional assistance at 330.725.8461 or 866.896.MCCC.

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