Applicant's Name_____________________________Date of Birth________Age____
Home Address_______________________City______________State____Zip_____
High School Attended_____________________________Date Graduated_________
School Address______________________City_______________State___Zip_____
Are you currently attending a college, vocational or trade school? If so, give name:
___________________________________________________________________
College, university, vocational or trade school you plan to attend:__________________
Have you been accepted____Degree/Course in which you plan to major____________
What is your current preferred career choice(s):_______________________________
__________________________________________
Signature of Applicant
Sponsor's Name______________________Title_____________________________
Relationship to Applicant________________________________________________
After completion, mail to the current President of CCTA. The acceptance or denial will be mailed to the applicants as soon as possible after the report of the committee is received by the CCTA President.