Survey

To be eligible for any of our career development programs listed in this application, you must have a high school diploma or equivalent.

For enrollment consideration for one of our career development programs, please follow these steps:

1. Complete the application fields below and click on SUBMIT when ready to submit.

2. Application will be processed and considered "received" upon receipt of the $50.00 non-refundable processing/assessment fee. Make check payable to KCCC and mail to

Knox County Career Center
ATTN: Admissions
308 Martinsburg Road, Suite A
Mount Vernon, OH 43050

OR

Call 740-393-2933 with credit card information.

3. Once the completed application and $50 application/assessment fee is received, applicant will be registered for a skill assessment date.

4. Applicant must provide proof of high school diploma or equivalency and complete any additional requirements established by individual program.

Please note: This application is contingent upon payment of the non-refundable $50 application/assessment fee. Applications will be considered in the order of the date payment has been received.

Please complete the following information. First Name
Middle Initial
Last Name
Any other name that may appear on previous documents?
Mailing Address (# & street or PO box)
City
State
ZIP
E-Mail Address
Home Phone w/Area Code
Cell Phone w/Area Code
Work Phone w/Area Code (optional)

(Required for Title IV Funding) If you are not a U.S. Citizen, indicate your U.S. Citizenship & Immigration Services status: (note, applicants speaking English as a second language may be required to take additional assessments to determine English proficiency levels) Permanent Resident	Refugee	Student Visa Holder
Other (please specify)

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Please select the program for which you are applying.

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Please complete the following information.

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Education History (select all that apply)

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How did you hear about Knox County Career Center Adult Education? (select all that apply)

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Are you applying for Title IV Funding (financial aid)?

(Required for Title IV Funding) Are you a U.S. Citizen?

(Required for Title IV Funding) If you are not a U.S. Citizen, indicate your U.S. Citizenship & Immigration Services status: (note, applicants speaking English as a second language may be required to take additional assessments to determine English proficiency levels)

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I will be paying the $50 application fee by the following method:

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I understand that completion of this application and payment of the processing and skill assessment fee is not a guarantee of program acceptance. Fee honored for one (1) year from date paid.

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I agree that upon submission of this application, I will comply with all school policies when on the Knox County Career Center campus and/or at school-related events.

Education History (select all that apply) High school diploma Career center/trade school Homeschooled Associate's degree	Bachelor's degree Graduate degree None of the above
GED. In what city and state was the testing facility?

How did you hear about Knox County Career Center Adult Education? (select all that apply) web site newspaper radio	friend/family former student paper catalog
Other (please specify)

*Please select the program for which you are applying.

*Please complete the following information.

*Education History (select all that apply)

*How did you hear about Knox County Career Center Adult Education? (select all that apply)

*Are you applying for Title IV Funding (financial aid)?