Start College Now Interest Form

Please complete the form below to indicate your interest in the Start College Now program at Fox Valley Technical College.

Important Note: The Start College Now team will communicate primarily via email. It is important that you provide a current email address.

Name*

First Name

Middle Name (optional)

Last Name

Date of Birth*

Gender*

Student Preferred Email Address*

Confirm Student Preferred Email Address *

Parent/Guardian Email Address*

Confirm Parent/Guardian Email Address *

Preferred Phone Number*

Ex: 920-555-5555

Home Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Please select any ethnic groups that apply to you.

American Indian or Alaska Native Asian Black or African-American Hispanic or Latino Native Hawaiian or Other Pacific Islander White Prefer not to answer

Select all that apply.

What grade are you currently in?

Please note that only high school juniors and seniors are eligible to take classes through Start College Now

What year will you graduate high school?

Please select the term you are interested in taking Start College Now courses

Please list the year you are interested in taking Start College Now courses

Are you planning on pursuing any of the following classes through Start College Now?

Automotive Youth Educational Systems (AYES) EMT Basic Culinary Nursing Assistant Phlebotomy None of the Above

What high school do you attend?

What is your high school counselor's name?

If possible, include your high school counselor's email address.

Application Deadline Acknowledgement*

I acknowledge that the deadline to submit my Start College Now application to my high school is March 1 for fall term and October 1 for spring term.