BLUE RIVER CAREER PROGRAMS NEW STUDENT APPLICATION 2025-2026 SCHOOL YEAR Step 1 of 2 50% SECTION ONEStudent Legal Name :* First Middle Last Student Phone Number :*Student Email :* Date of Birth :*Legal Gender :Select OptionFemaleMaleGrad Year :*Select One202620272028Home School :*Select OptionSHS – Shelbyville High SchoolTCHS – Triton Central High SchoolSWHS – Southwestern High SchoolMHS – Morristown Jr. Sr. High SchoolWHS – Waldron Jr. Sr. High SchoolStudent Mailing Address :* Street Address City ZIP Code Parent/Guardian Home Address (if different) : Street Address City ZIP Code Legal Guardian Father Mother Parents Guardian Father Name :* First Last Father's Phone Number :*Father's Email Address :*Mother Name :* First Last Mother's Phone Number :*Mother's Email Address :*Guardian Name :* First Last Guardian's Phone Number :*Guardian's Email Address :*Student Accommodations (IEP, ILP, or 504) Yes No Select Accommodations IEP ILP 504 SECTION TWOChoose your first and second program choices.First Choice ProgramPlease choose your first type of program from the dropdown menu.Select your first choiceAuto Collision RepairAutomotive ServicesConstruction TradesCriminal JusticeCulinary ArtsDiesel ServicesFire & Rescue yr. 1Education ProfessionsHealth Sciences Yr 1 CNA/ Yr 2 CapstoneHealth Sciences Yr 1 CCMA/ Yr 2 CapstoneHuman & Social ServicesWelding TechnologyWork Based Learning* Dual College Credit May Be Available* Dual College Credit May Be Available* Dual College Credit May Be Available* Dual College Credit May Be Available* Dual College Credit May Be Available* Dual College Credit May Be Available● - Minimum Age Requirement (17 by May 2026)* Dual College Credit May Be Available# ^ - Minimum Age Requirement (16 by May 2026) With Criminal History Report Required # ^ - Minimum Age Requirement (17 by May 2026) With Criminal History Report Required * Dual College Credit May Be Available* Dual College Credit May Be AvailableSecond Choice ProgramPlease choose your first type of program from the dropdown menu.Select your second choiceAuto Collision RepairAutomotive ServicesConstruction TradesCriminal JusticeCulinary ArtsDiesel ServicesFire & Rescue yr. 1Education ProfessionsHealth Sciences Yr 1 CNA/ Yr 2 CapstoneHealth Sciences Yr 1 CCMA/ Yr 2 CapstoneHuman & Social ServicesWelding TechnologyWork Based Learning* Dual College Credit May Be Available* Dual College Credit May Be Available* Dual College Credit May Be Available* Dual College Credit May Be Available* Dual College Credit May Be Available* Dual College Credit May Be Available● - Minimum Age Requirement (17 by May 2026)* Dual College Credit May Be Available# ^ - Minimum Age Requirement (16 by May 2026) With Criminal History Report Required # ^ - Minimum Age Requirement (17 by May 2026) With Criminal History Report Required * Dual College Credit May Be Available* Dual College Credit May Be AvailableSECTION THREE - Student• Briefly describe why you want to take a career program class :*• List classes you have taken in high school and work experiences which relate to your career program choice :*• Do you have any health problems or physical limitations that Blue River Career Programs should be aware of or may require special accommodations?* No Yes • Please describe :*This field is hidden when viewing the formSECTION FOUR - Home School CounselorThis field is hidden when viewing the formStudent Legal Name :* First Last This field is hidden when viewing the formCurrent GPA :This field is hidden when viewing the formCredits earned :This field is hidden when viewing the formSTN :This field is hidden when viewing the form# of days absent year to date :This field is hidden when viewing the formDiploma Track :Please diploma track from the dropdown menu.Core 40Academic HonorsTechnical HonorsGeneralCert. of CompletionThis field is hidden when viewing the formIEP : Yes No This field is hidden when viewing the form504 : Yes No This field is hidden when viewing the formSAC/AtoE : Yes No This field is hidden when viewing the formIvy Tech Community College C number if applicable :This field is hidden when viewing the formPassed English GQE : Yes No This field is hidden when viewing the formPassed Algebra GQE : Yes No This field is hidden when viewing the formIs This Class Being Audited? : Yes No This field is hidden when viewing the formIf Yes : Semester 1 or Semester 2 or Both This field is hidden when viewing the formDiscipline Concerns (if any) :This field is hidden when viewing the formComments :This field is hidden when viewing the formCounselor’s Signature :This field is hidden when viewing the formDate:*This field is hidden when viewing the formSECTION FIVE - BRCPThis field is hidden when viewing the formBRCP Director: Approved : Yes No This field is hidden when viewing the formDirector’s Signature :This field is hidden when viewing the formDate :This field is hidden when viewing the formComments :
