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2016-2017 CCCC Senior Exit Form
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* Indicates required question
Name (First, Last)
*
Your answer
Program
*
Choose
Allied Health
Culinary
Cosmetology
Construction
Automotive
Diesel
Police Science
Computer Networking
Welding
Sending School
*
Choose
Clarion
Clarion-Limestone
AC Valley
Keystone
North Clarion
Redbank Valley
Union
1. Upon graduation I plan on: (select all that apply)
*
Entering the workforce after graduation
Enrolling in college or technical school
Enlisting in the military after graduation
I am unsure of my plans after graduation.
Required
Please provide more information based on your response to question #1 above.
If entering the workforce, what company will you be working for?
Your answer
Please describe your job and what you will be doing.
Your answer
Is your job related to your program at the Career Center
Choose
Yes
No
If enrolling in college or technical school, what is the name of the school?
Your answer
What will you be studying (what is your major)?
Your answer
You currently live with
Parents
Guardian
Friend
Other relative
Clear selection
Do you have a child?
Yes
No
Clear selection
Home Phone Number:
Your answer
Cell Phone Number:
Your answer
Email Address:
Your answer
Mailing Address:
Your answer
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