FULL-TIME APPLICATION Today's Date Date Format: MM slash DD slash YYYY Section BreakName* First Last Mailing Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Physical Address* Same as mailing address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Mobile Phone*Home PhoneSection BreakSemester*FallSpringHS/Adult*HSAdultStatus on first day of CKTC attendance?789101112Where do/did you attend high school?*Select schoolAnadarkoBinger-OneyBoone-ApacheCarnegieCementCyrilFort Cobb-BroxtonGracemontHintonHydro-EaklyLookeba-SicklesMountain View-GoteboRiversideVerdenOtherSection BreakWhat type of course?*Onsite CourseOnline CourseOnsite ProgramSelect a ProgramAuto Service TechnologyBiomedical Sciences (HS only)Business Information TechnologyConstruction TechnologyCosmetologyCulinary ArtsDiesel Service TechnologyDigital Imaging and Print TechnologyEarly Care and EducationEarly TechHealth CareersHeating, Ventilation, Air ConditioningLicensed Practical Nursing (Adult only)Occupational Therapy Assistant (Adult only)Physical Therapist Assistant (Adult only)Pre-Engineering (HS Only)WeldingWork PrepAdult Basic Ed/Financial Literacy for AdultsUndecidedAttendance Options*AMPMAll DayOnline ProgramSelect a ProgramAdministrative AssistantMedical Office AssistantVirtual (BITE - HS Credit Only)Geometry (HS Credit only)Algebra II (HS Academic Credit)Computer I (HS Credit Academic)Computer II (HS Academic Credit)Section BreakReceive text alerts?*YesNoReceive campus newsletter?*YesNoHave you been convicted of a felony?*YesNoHighest Level of Education*Less than a HS DiplomaHigh School Diploma/HS EquivalencySome CollegeTechnology DiplomaAssociate DegreeBachelor DegreeMaster DegreeGEDHave you been a student here before?*YesNoWhat program?*If you could have records under another name, what is that name?
