High School High Tech Student Enrollment

The Able Trust

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850.224.4493

[email protected]

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High School High Tech Student Enrollment Form

Please complete this form for each High School High Tech student. Fields with an asterisk (*) are required.

* Previous Years Student Participated in High School High Tech
Please select from the drop-down menu.

* Student First Name

* Student Last Name

* HSHT Site/County
Please select your county from the drop-down menu.

* High School
Please select your school from the drop-down menu.

* Student Home Address (House #, Street name, Apt.#)

* City

* State

* Zip Code

* Home Phone Number

* Email Address

* Student's Date of Birth:
Please enter in format shown below and confirm the year of birth is correct.

Last 4 Digits of Social Security Number

* Grade

* Gender

Race

* Parent/Guardian First Name

* Parent/Guardian Last Name

Parent/Guardian Phone

Parent/Guardian Email

What is the primary language that is spoken in the home? Please select from the list below.

English Spanish Haitian/Creole Other

What is the parent or guardian's highest level of education? Please select from the list below.

Less Than High School High School Diploma or Equivalent Some College Undergraduate Degree Postgraduate Degree

Is there Internet access in the home?

Yes No Don't know

Type of Disability Documentation
Please select from drop-down menu.

* Was the Parental Release Form obtained?
Copy of Parental Release Form can be found here: Parental Release Form

Yes No

* Primary Student's Disability
Please select from the drop-down menu.

HSHT Diploma Track
Please select from the drop-down menu.

Anticipated Graduation Date (mm/yyyy)

* Student was provided enrollment packet.

Yes No

Services and Support Received:
Please check those services student has received from the list below.

Division of Blind Services (School-to-Work or Transition Programs) Career, Technical and Adult Education (Enrolled in CTE Course in High School) Division of Vocational Rehabilitation (Pre-ETS Services, Transition Programs) Florida Department of Commerce (Training Programs, SNAP) Career Source Florida (Summer Youth Programs)

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CONTACT INFO

850-224-4493
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[email protected]
E-mail

1709 Hermitage Blvd., Suite 100
Tallahassee, FL 32308
Main office

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Hours of Operation

8:30 am – 5:00 pm ET
Monday – Friday

The Able Trust is a public 501(c) 3 charity that promotes employment opportunities for persons with disabilities in Florida. Established by the Florida Legislature in 1990, The Able Trust serves as the direct support organization for the Florida Division of Vocational Rehabilitation.

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1709 Hermitage Blvd., Suite 100
Tallahassee, FL 32308
Phone: 850.224.4493

[email protected]

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