Last Name First Name Middle

Street Address City State Zip Code County

Social Security No. Birthdate Age   Home Phone No.

Male   Female   E-Mail Address     Message/Cell Phone

Course Preference Business Systems Technology Collision Repair Technology Computer Information Technology Cosmetology Cosmetology (Nail Tech Only) Early Childhood Education General Metals Industrial Maintenance Machine Tool Technology Motorcyle/ATV Repair Residential Maintenance  Please be sure to CLICK on your Course Preference so that it is highlighted. NOTE:  If you are interested in Practical Nursing, please call the school for a different application to be mailed to you.                                

Full-Time Part-Time Flex Student            Date you are available to enroll

Education Below eight grades Eighth Grade Ninth Grade Tenth Grade Eleventh Grade High School Diploma GED Training beyond H.S./GED College Graduate High School Attended

Prior Training from a college or technical school

Employer Hours per Week Miles (one way) to TTC

Veteran Yes No
Are you eligible to register for the Federal Draft? Yes No
If yes, have you registered for the Federal Draft? Yes No
Are you incarcerated? Yes No

Training: Briefly give length and description of any related courses you have taken and place received:

Experience: Briefly describe any work-related experience:

Goals: Briefly describe what you wish to accomplish and where you would like to work after training:

Citizenship U.S. Citizen Foreign-Temporary Foreign-Permanent Foreign Country Foreign students must present proof of permanent residency in the U.S. 

Race/National Origin (This information is voluntary and will be used for statistics only. Asian/Pacific American Indian Black-Not Hispanic Hispanic White-Not Hispanic

In accordance with the Privacy Act of 1974, applicants for admission and enrolled students are advised that the requested disclosure of their Social Security numbers to the Office of Admissions is voluntary. Students who do not provide the Center with their Social Security numbers will be assigned special nine-digit numbers. Students are notified, however, that only the Social Security number may be used as an identifier for grants, loans, and other financial aid programs according to federal regulations.

I understand that withholding or giving false information on this application may make me ineligible for admission to or continued enrollment at the Tennessee Technology Center at Paris. I certify that all information on this application is true and complete. Further, if I am admitted to the Tennessee Technology Center at Paris, I agree to abide by the rules and regulations of this institution.

Thank you for completing this application. We look forward to having you as a student soon! If you have any questions, or would like to tour the Center, please feel free to contact Student Services at (731) 644-7365 Monday-Friday from 7:30-4:00.