Social Security Number
Date of Birth
Permanent Mailing Address
May we send text messages to the above cell phone number?
High School Attending
Current High School GPA
Have you ever failed a course in the High School Dual Credit Program?
If yes, which semester(s) and from what university/technical college?
For which semester will you be enrolled for dual credit?
Are you interested in attending Lake Area Tech after graduation?
Which program are you interested in?
Have you applied for the above program?
Please select yes for all that apply:
Black or African American
Native Hawaiian or Other Pacific Islander
Are you Hispanic/Latino ?