Monongalia County Technical Education Center Health Occupations Application

School Year *

www.mtec.mono.k12.wv.us

MTEC Mission Statement

MTEC prepares students to succeed in high demand occupations and post-secondary education by promoting quality instruction, active engagement and collaborative partnerships.

Core Values:

Every student has the opportunity to be career and college ready
Performance–based learning narrows the skills gap
Learning is rigorous, relevant, diverse and promotes positive relationships

Date * +

Student Information

First Name *

Middle Name

Last Name *

Maiden Name

List any other name you have used for work or school, including former names:

Social Security Number *

Street Address *

City *

State *

Zip *

Home Phone *

Cell Phone *

Work Phone

Email *

Date of Birth * +

Are you a United States citizen? *

Yes

Country of citizenship: *

Green Card/VISA type: *