For Office Use:
For High School Use:
NCWise #____________________
SS#_________________________
ABTech ID#_____________________
340 Victoria Road, Asheville, NC 28801
The Career and College Promise Application for Admission for High School Students
Career Technical Education Certificate or College Transfer Pathway
Juniors and Seniors: Complete this application and obtain all required signatures for approval.
SPRING 2013
PLEASE PRINT IN BLACK OR BLUE INK Application Term:
(New Application required for each semester of
enrollment.)
STUDENT INFORMATION
Last Name
First Name
Middle Name
Street Address
City
Home Phone
Cell Phone
Ethnicity: (Please select one.) - Optional
Race: (Please select all that apply.) - Optional
□ Hispanic/Latino
□ American Indian/Alaska Native
□ Non-Hispanic/Latino
□ Asian
County
State
Email Address
Zip Code
Date of Birth
□Male
□Female
□ Native Hawaiian/Other Pacific Islander
□ White
□ Black/African American
□ Other
College Educational Goals: (Please select one.)
Current Employment Status: (Please select one.)
□ Transfer Credit to College
□ Unemployed, not seeking employment UN
□ Employed 21-39 hours/week E3
□ Degree, Diploma or Certificate
□ Unemployed, seeking employment US
□ Employed 40+ hours/week E4
□ Enhance Present Skills
□ Employed 1-10 hours/week E1
□ Personal Enrichment
□ Employed 11-20 hours/week E2
□ Goal Unknown
Highest educational level completed by your father: (Please select one.)
□ 8 □ 9 □ 10 □ 11 □ 12 □ GED □ 13 Adult High School Diploma □ Post High School Vocational
□ 15 Associate’s Degree □ 16 Bachelor’s Degree □ 17 Master’s Degree or Higher
Highest educational level completed by your mother: (Please select one.)
□ 8 □ 9 □ 10 □ 11 □ 12 □ GED □ 13 Adult High School Diploma □ Post High School Vocational
□ 15 Associate’s Degree □ 16 Bachelor’s Degree □ 17 Master’s Degree or Higher
EMERGENCY CONTACT INFORMATION
Name
Phone #:
Relationship
HIGH SCHOOL INFORMATION
High School
Will you be a junior or senior when you take
this class? Circle One:
JUNIOR OR SENIOR
STUDENT SIGNATURE: _____________________________________________
HS Graduation Date:
___________/____________
Month / Year
Date: ______________________________
Revised 10/02/12
Courses I want to take at A-B Tech: ___________________________________________________________________________________________
Select your Career and College Promise Pathway (You may only select one College Transfer and one Career Pathway.)
Career and Technical Education Program Pathways (Assessment Test Scores are not required for these pathways)
□ Automotive Technology Diploma (D60160H1)
□ Industrial Maintenance Certificate (C50240H1)
□ Criminal Justice Exploration Certificate (C55180H1) □ Machining Technology Certificate (C50210H1)
□ Early Childhood Certificate (C55220H1)
□ Web Technology/Web Design Certificate (C25290H1)
□ Entrepreneurship Certificate (C25490H1)
□ Welding Certificate (C50420H1)
□ Heavy Equipment Technology Diploma (D60240H1) □ Building Construction Science Diploma (D35190H1)
□ Computer Basics Certificate (C25260H1)
□ Mechanical Engineering Pre-Engineering Certificate (C40320H1)
□ Human Services Studies Certificate (C45380H1)
College Transfer Program Options (Assessment Test Scores are required for these pathways)
□ Business and Economics (P1012B)
□ Engineering and Mathematics (P1042B)
□ Life and Health Sciences (P1042A)
□ Humanities and Social Science (P1012A)
College Readiness Benchmarks used: __________________________________________________________________________
□ Provisional Status Student: May register only for college mathematics (MAT) and college English (ENG) within chosen pathway. Must first
successfully complete mathematics and English courses with a grade of “C” or higher before being eligible to register for other courses in the
Pathway. If student does not meet college readiness benchmarks, check this box and select pathway above.
Principal/Administrator Certification
____ For College Transfer Pathway and Career Technical Education Pathway Students: The applicant is a junior/senior (circle one) and has a
weighted GPA of _________ as of ___________ (date of GPA). I ____do waive the high school GPA requirement for the selected Career and
Technical Education Pathway and understand I cannot waive this requirement for a College Transfer Pathway. I certify that this student is eligible to
participate in the Career and College Promise Program as defined by the North Carolina Community College System.
____ For Provisional College Transfer Pathway Students: The applicant is a junior/senior (circle one) and has a weighted GPA of ______ as of
_________ (date of GPA). The applicant has completed two years of high school English and high school Algebra II (or higher level math) with a
grade of “C” or higher. The student understands final approval is required by the college president or designee. I certify that this student is eligible
to participate in the Career and College Promise Program as defined by the North Carolina Community College System.
_________________________________________________________
Signature of School Principal/Administrator or Designee
___________________________
Date
________________________________________________________ CC Approval
________________________ Date
============================================================================================================
College Readiness Benchmarks on Approved Diagnostic Assessment Tests. Please Circle each benchmark reached.
Test
English
Reading
Mathematics
PLAN
PSAT
15
17
19
49
50
50
Asset
(NCCCS Cut Score)
41 Writing
41 Reading
41 Numerical Skills
and 41 Int. Algebra
Compass
(NCCCS Cut Score)
70 Writing
81 Reading
47 Pre-Algebra and
66 Algebra
Students may also use the following SAT and ACT scores to meet benchmarks:
English
Critical Reading
Mathematics
SAT
500
500
500
English
Reading
Mathematics
Official or school reproduced Assessment Scores must accompany this application.
Approved Pathway Courses (for
high school counselors use):
Revised 11/29/12
ACT
18
21
22
Accuplacer
(NCCCS Cut Score)
86 Sentence Skills
80 Reading
55 Arithmetic and 75
Elem. Algebra