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We will communicate with you using the phone number and/or email you provide, So please make sure your entries are accurate.

First Name

Middle Name

Last Name

Please type your name as it appears on legal documents.

Student Email

Gender

Male

Female

Student Phone Number

We communicate important messages to students via text message. If you do not currently have a mobile phone, please list a mobile phone number of a trusted family member or friend so that you can receive messages.

Social Security Number

Providing a social security number helps us to track your accomplishments and share resources with you. As always, your data is kept secure and confidential.

Home High School

Academy Type

Country of Birth

Current Grade Level

Primary Spoken Language

Hispanic/Latino Ethnicity?

Student Race

Date of Birth.

Age

Street Address

City

State

Zip Code

TO BE COMPLETED by PARENT/GUARDIAN:

Emergency Contact Information: All parties whom we are able to be contacted in case of an emergency or school release

Primary Guardian

First Name

Last Name

Parent Guardian Primary Phone Number:

Home Phone Number

Cell Phone Number

Work Phone Number

Work Phone Number:

Cell Phone Number:

Relationship to Student

Are you actively serving in the military or a military veteran?

Remove

Secondary Guardian

First Name

Last Name

Parent Guardian Primary Phone Number:

Home Phone Number

Cell Phone Number

Work Phone Number

Work Phone Number:

Cell Phone Number:

Relationship to Student

Are you actively serving in the military or a military veteran?

Add More PARENT/Guardian

Are you a returning Area 31 Career Center Student?

Yes

Parent/Student Information:

Release of Permanent Record: Student records concerning my son/daughter may be transferred to Area 31 Career Center from his/her home high school.

A student cannot graduate from high school unless all requirements of the home high school are met. Students must meet the required prerequisites of successfully completing Algebra 1 and English 10 for academic credit for consideration in an Area 31 Career Center Program.
Students enrolling in Criminal Justice, Cybersecurity, Medical Assisting or Pre-Nursing will be assigned to either Brownsburg or Wayne Township location based on consideration such as program enrollment and student’s home high school. Placement decisions are made by the Area 31 Career Center Administration.
Equal Opportunity; Area 31 does not discriminate on the basis of race, color religion, gender, national origin, age or individuals with disabilities, including limited English proficiency, programs or employment policies as required by the Indiana Civil Rights Act (i.c.22-9.1) Title VI and VII (Civil Rights Act of 1964), equal pay act of 1973, Title IX (educational amendments), and Section 504 (Rehabilitation Act of 1973)
Area 31 Career Center may release my son/daughter’s grades to postsecondary institutions for the purpose of dual credit and/or articulation.

Statement of Cooperation: I have discussed my career plans with my parent(s) and/or Guardian(s) and we have reviewed this application. We understand that this form is merely an application and not guarantee of placement in the career center program of my choice.

I also understand and agree that should I be placed in a career program, I will abide with all rules of the program including dress and safety requirements of the particular class. A VIOLATION OF THE SAFETY RULES, WHICH COULD RESULT IN INJURY OR DAMAGE TO EQUIPMENT, IS A CAUSE FOR IMMEDIATE DISMISSAL FROM THE PROGRAM.

Electronic Student Signature.

Please type your full legal name, as this will serve as your electronic signature. This signature acknowledges that the information provided in this form is correct and that you agree to the releases contained in this registration form.

Date

Area 31 Career Center

2026-2027

Enrollment Form

TO BE COMPLETED by PARENT/GUARDIAN:

Primary Guardian

Secondary Guardian

Parent/Student Information: