Survey | Miami Valley Career Technology Center

Student Follow-Up

= Required

First Name (Use legal name)

Last Name (Use legal name)

Birth Date

mm/dd/yyyy

Personal Email Address

Program Teacher

Graduation Year

Address

City

State

Zip

Home Phone

(###) ###-####

Cell Phone

(###) ###-####

Please enter any social media platforms used

List your profile/displayed name that you use with social media

What type of internet do you have at home for remote learning?

Additional Family/Friend Contact

First Name

Last Name

Relationship

Address

City

State

Zip

Home Phone

(###) ###-####

Cell Phone

(###) ###-####

Email Address

Additional Family/Friend Contact

First Name

Last Name

Relationship

Address

City

State

Zip

Home Phone

(###) ###-####

Cell Phone

(###) ###-####

Email Address

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MVCTC MISSION STATEMENT

We are dedicated to providing premier educational choices and advanced employment preparation for youth, adults, and organizations of the Miami Valley.

REPORT BULLYING OR HARASSMENT

NON-DISCRIMINATION POLICY

TITLE IX RESOURCES

SEMI-ANNUAL BULLYING REPORT

EMERGENCY MANAGEMENT PLAN

PRIVACY STATEMENT