Lehigh Career & Technical Insitute

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Account Information

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*Email Address:

*Password: (8-20 characters with no spaces)

*Verify Password: (enter password again to ensure accuracy)

Personal Information *Required

Source:

*First Name:

*Last Name:

*Address:

*City:

*State:

*Zip/Postal Code:

Day Phone:

*Birthdate: / / (mm/dd/yyyy)

*Gender:

*Ethnicity:

*Economically Disadvantaged? *A student shall be regarded as disadvantaged is he/she has a school recognized academic, socioeconomic, and cultural or other disadvantage status.

*Displaced Homemaker?

*Disabled? *A student shall be regarded as disabled if he/she has a school-recognized physical or mental condition that requires a specially designed vocational education curriculum or special services outside a regular vocational curriculum.

*Single Parent?

Special Needs:

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