Student Application
Instructions: Please PRINT and provide all of the following information. Only students completing 9th grade are eligible to apply. Completed Student Applications are to be returned to your counselor no later than February 1, 2016.
Name: ______ID # ______
Last First
School (Circle): TR TT TW Counselor: ______
Mailing Address: ______
City: ______State: ______Zip: ______
Home Phone: (______) ______- ______Student Cell Phone: (______) ______- ______
Student Email Address: ______
Parent/Guardian Name: ______Last First
Work Phone: (______) ______- ______Parent Cell Phone: (______) ______- ______
Parent Email Address: ______
Please select which careers interest you. If you select “other”, please briefly name or describe that choice.
_____ Truck Technician _____ Diesel Mechanic
_____ Service Manager _____ Heavy Equipment Service Technician
_____ Power Plant Technician _____ Parts Manager
_____ Owner, Diesel Repair Business _____ Automotive Technician
_____ Engineer _____ Engineer Technician
_____ Other (Please describe) ______
(over)
List all student activities (clubs and sports teams) for which you are a member:
Briefly describe why you should be selected as a member of the Thornton Township Academy of Truck & Diesel Technology – Powered by Navistar.
The Thornton Township Academy of Truck and Diesel Technology – Powered by Navistar is housed in the Vocational Technical Building at Thornton Township High School and is a three-year curriculum. The program of study includes a double period course during 10th grade, a triple period course during 11th grade, and a triple period course combined with a possible cooperative education experience during 12th grade.
Parent/Guardian Consent
I, ______, have read, understand, and consent to
(Print Parent/Guardian Name)
______applying for membership in the Thornton Township
(Print Student Name)
Academy of Truck & Diesel Technology – Powered by Navistar. I agree and support his/her participation and
abide by all Thornton Township High School District 205 rules and requirements.
Parent/Guardian Signature: ______Date: ______
IMPORTANT: Thornton Township Truck & Diesel Academy – Powered by Navistar does not discriminate on the basis of race, color, national origin, age, religion, non-disqualifying handicapping condition or gender in its educational programs or employment.
Thornton Township Academy of Truck & Diesel Technology – Powered by Navistar!
15001 S. Broadway
Harvey, IL 60426
Phone 708-225-4193 Fax 708-225-5046