Career Interest Form - Springfield-Clark Career Technology Center, Springfield, Ohio

First & Last Name *
Address *
City *
State *	example: OH
Zip Code *
Phone Number *
Birth Date *	ex: mm/dd/yy
Email Address
Current High School *
Current Grade *
Gender *
Career Choice 1 *
Career Choice 2
Career Choice 3
Why are you considering Springfield-Clark CTC?

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Springfield-Clark Career Technology Center
1901 Selma Road
Springfield, OH 45505

Phone: 937 325 7368
Site: www.springfieldclarkctc.org