Dual Enrollment Application Year___________
Current High School: □ Bayshore □ Braden River □Lakewood Ranch □ FLVS
□ Charter/Private/ Home School □ Manatee □Palmetto
□Parrish Community □Southeast
Requested Admission Date: □ Fall □
Spring Birth Date: SSN#: SSSSSSSSSSSSSSSSS
Student Name: Application Date: _________________
(First Name) (Last Name)
Address: Student Cell:
City, State, Zip Code: Parent Cell: _______________________________
Parent Name: Parent Signature:
Parent Email Address: Home Phone:
Student Email Address: Student Signature: ______________________________
Grade level at time of entry at MTC: (check one) □11 □12 Do you need bus transportation to and from MTC? □Yes □No
Do you qualify for free or reduced lunch?: □Yes □No
CHOOSE YOUR FIRST AND SECOND CHOICE:
TO BE COMPLETED BY H.S. COUNSELOR
Student Alias ID FLEID Social Security Number
(Required data for DOE. MTC is using a separate database system)
Student is classified: □Regular Class □Exceptional Student (ESE)/ 504 Plan □ (Include IEP/ 504 with application)
Preferred scheduled time: □Part-time □Full-time
Passed all state required assessments to graduate: □Yes □No
I verify that the student has at least a 2.0 GPA for dual enrollment at MTC.
_____________________________________ ________________
(Printed Name) (Signature) (Date)
MANATEE TECHNICAL COLLEGE USE ONLY
Basic Skills Assessment results: Reading:__________ Math:__________ Language:__________
Date: __________ Accepted for program:_____________________
Notes: ______________________________
MTC_DUAL ENROLLMENT APPLICATION Rev. 02/02/2021
Part Time (Monday- Friday 8am-11am)
Accounting Operations
(August Entry Only)
Administrative Office Specialist
(August Entry Only)
Automotive Service Technology
(August Entry Only) (Juniors Only)
Building Trades & Construction Design
(August Entry Only)
CNC Production Specialist
(August Entry Only)
Drafting
(August Entry Only)
Additional Information:
Make sure to fill out the online application on
www.manateetech.edu
. Complete the “to do list” on your
portal. Your counselor will notify you once you have been
ACCEPTED.
Once you have been accepted please click on the link here to
fill out Text Book Request Form
.
Students have up to six weeks from admittance to take the
Basic Skill Assessment Test. The Basic Skills Assessment
test is not a requirement for admittance, but it is a
graduation requirement.
*For EMT/ Fire Fighter programs, information sessions are
mandatory. Please speak to Mark Toler, Career Counselor,
prior to completing an online MTC application.
Administrative Office Specialist
Adv. Manufacturing & Production Tech.
Automotive Collision Technology Tech.
Automotive Service Technology
Building Trades & Construction
Computer System & Information Technology
CNC Production Specialist
Digital Photography Technology
Electrician (August Entry Only)
*EMT (Seniors Only)
(August Entry Only)
*Fire Fighter (Seniors Only)
(January Entry Only)
Fundamental Food Service Skills (Culinary)
Heating, Ventilation, Air-Cond. Refrig. (HVAC)
(August Entry only)
Optometric Assisting (Seniors Only)
(August Entry Only)
Patient Care Technician (Seniors Only)
(August Entry Only)
Pharmacy Technician (Seniors Only)
(August Entry Only)
Professional Culinary Arts & Hospitality
(August Entry Only)
