2025-2026 Fall Term Fred K. Marchman Technical College Early Childhood Education Apprenticeship Application

PLEASE READ BEFORE PROCEEDING WITH APPLICATION

The following steps must be completed to finalize your application

Step 1: Complete the Online Application.

Step 2: Provide a copy of your High School Transcript or GED Transcript if you have not already submitted one (not required for Pasco graduates). This step is listed on the Early Childhood Education – APPR webpage.

Please use a computer or laptop to complete this application.

Please mark below*

I have read and understand the above application procedures.

Which program are you applying for?*

Prior Enrollment Status:*

First Name*

Middle Name*

Last Name*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Date of Birth*

Date

Primary Phone Number*

Please enter a valid phone number.

Secondary Phone Number

Please enter a valid phone number.

Social Security Number*

123-00-6547

Pasco County Student ID

If applicable. Must be 6 digits.

Gender*

Birthplace: City*

Birthplace: State or Country*

Ethnicity: Hispanic or Latino*

YesNo

Race:*

Single Ethnicity:*

Citizenship:*

Is English your first language?*

YesNo

English is not my first language, my first language is:

Please write in your first language.

Highest Grade Completed:*

Please provide the last date you attended school, an approximate ending date

Have you ever attended a school in Florida?*

YesNo

In which Florida county have you attended school?

Have you previously been enrolled in any Adult Education Program or Technical Program?*(If you select YES, Please provide dates of enrollment below)*

YesNo

Name of institution

Starting Date of Enrollment (Dates may be approximate)

Ending Date of Enrollment (Dates may be approximate)

I understand that if I am requesting credit for courses completed at another post-secondary institution, I must provide an official transcript at the time of application to the admissions advisor/career specialist. All credits must be accepted towards the current program prior to enrollment.*

I confirm that I have read and agree to the Transfer Credit Policy

I am requesting transfer credits from another institution.*

Yes (please upload a copy of your transcript on the application page)No

Parental Status*

Single ParentSingle Pregnant WomanBoth - Single Parent and PregnantNot Applicable

Do any of the following apply to you as a Displaced Homemaker:*

Participant is providing services to family members in the home and is the dependent spouse of a member of the Armed Forces on active dutyParent whose youngest child will become ineligible (at age 16) to receive assistance under the program for Aid to Families with Dependent Children under Part A of the Title IV of the Social Security ActBeen dependent on public assistance or on the income of a relative but is no longer supported by such incomeWorked as an adult primarily without remuneration to care for home and familyNot Applicable

Are you a United States Veteran?*

Employment Status*

Name of Childcare Center Currently Employed By*

Name of Current Childcare Center Director*

Phone Number of Current Employer*

Please enter a valid phone number.

Address of Current Employer*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Have You Been Referred By An Agency?*

How did you hear about us?*

Emergency Contact Acknowledgement*

I hereby authorize Fred K. Marchman Technical College to reach out to the following contacts in case of emergency. In case of medical emergency care, I authorize FKMTC to provide this information to medical personnel.

Emergency Contact #1

First NameLast Name

Relationship of Emergency Contact #1

Phone Number of Emergency Contact #1

Please enter a valid phone number.

Emergency Contact #2

First NameLast Name

Relationship of Emergency Contact #2

Phone Number of Emergency Contact #2

Please enter a valid phone number.

Emergency Contact #3

First NameLast Name

Relationship of Emergency Contact #3

Phone Number of Emergency Contact #3

Please enter a valid phone number.

Primary Care Physician Name

First NameLast Name

Primary Care Physician Phone Number

Please enter a valid phone number.

Do you have any of the following medical diagnosis?*

Do you have any additional health problems or allergies of which the school should be aware of?*

Do you take any routine medications?*

YesNo

If you answered yes to the above, please list any routine medications:

Medical Emergency Care Treatment Authorization

In case of accident or serious illness, I authorize the school to make whatever arrangements are necessary to provide care and treatment. I agree to pay all expenses incurred by the handling of this emergency care.

I hereby authorize Pasco County Schools to release and exchange my confidential information, related to emergencies, to Pasco County Fire Rescue and/or the nearest hospital, in order to provide medical care on my behalf, if I am unable to provide the information.

By signing below I agree with the Medical Emergency Care Treatment Authorization terms and conditions above.*

First NameLast Name

What is your purpose for attending Fred K. Marchman Technical College (please check one)*

Employment - I am attending school in order to obtain employment in the field of my program of study.Personal Enrichment – I am attending school to increase my skills and do not plan to seek employment in the field of my program of study.

Please read the FKMTC Student Code of Conduct before proceeding any further.

I understand that I must read and agree to the FKMTC student code of conduct and technical program catalog to finalize this application (both documents may be found at www.fkmtc.edu.)*

I have read and agree to the FKMTC student code of conduct and technical program catalog

Family Educational Rights and Privacy Act (FERPA)

Authorization for Access to My Education Records
Fred K. Marchman Technical College provides for the confidentiality of student records in accordance with the Family Educational Rights and Privacy Act (FERPA), as amended. Accordingly, in order for us to be able to discuss your education record with your parents, spouse, or other persons who you designate, you must provide your authorization. “Education record” includes those records, files, documents and other material that contain information directly related to the student and are maintained by the school or a person acting for the school. This includes admission, enrollment, financial aid, academic, and disciplinary records. An education record includes information recorded in any medium but does not include personal notes, records only available to law enforcement personnel, employment records, or medical records.

FERPA: Choose One*

I do NOT authorize Fred K. Marchman Technical College to release my education records to any person, agency or organization.I do authorize Fred K. Marchman Technical College to release my education records to the person, agency or organization listed below. (YOU MUST COMPLETE AT LEASE ONE CONTACT NAME BELOW)

In accordance with the Family Educational Rights and Privacy Act (FERPA), I authorize Fred K. Marchman Technical College to release my education record to the following persons, agencies, or organizations for the purpose of keeping such persons, agencies, or organizations informed of my progress at Fred K. Marchman Technical College:

Name of FERPA Contact #1*

First NameLast Name

Relationship to Student of FERPA Contact #1*

Phone Number of FERPA Contact #1*

Please enter a valid phone number.

Name of FERPA Contact #2

First NameLast Name

Relationship to Student of FERPA Contact #2

Phone Number of FERPA Contact #2

Please enter a valid phone number.

Name of FERPA Contact #3

First NameLast Name

Relationship to Student of FERPA Contact #3

Phone Number of FERPA Contact #3

Please enter a valid phone number.

I understand that by clicking below, I am waiving my rights of nondisclosure of these records under federal law only to the persons or entities specifically listed. This release does not permit the disclosure of these records to any other persons or entities without my written consent or as permitted by law. This consent will remain in effect until revoked by me, in writing, on the current authorization form and a new authorization form is completed. This form may be accessed in the Administration Office of Fred K. Marchman Technical College.

I am waiving my rights of nondisclosure

Transcript Release Authorization

I hearby authorize Fred K. Marchman Techincal College to obtain a copy of my transcripts from the Pasco County School I attended. I understand this is strictly for the use of the Admissions Office to process my application.

Please provide high school name of graduation*

Pasco County Student ID

If applicable. Must be 6 digits.

Please provide year of graduation*

By signing below I confirm that I have authorize the release of my transcripts*

First NameLast Name

PASCO COUNTY SCHOOLS MEDIA RELEASE FORM

Pasco County Schools (the District) strives to celebrate the accomplishments of its students by sharing information with the community. To do this, the District may submit press releases to local media (newspapers, radio, television, online news blogs) that include student names, student work,student photographs, and video and/or voice recordings.

In addition, the District may choose to publish and/or display this information in District sponsored publications, at various school or public functions, on the District’s local cable channel, website(s) and various social media channels, or in the school yearbook. While the intent of this practice is to be informative and celebratory, the District recognizes that concerns may arise regarding a student’s right to privacy.

Pursuant to the Federal Family Educational Rights and Privacy Act (FERPA), school districts are not permitted to release "school directory information" unless applicants exercise their right of refusal. Under the FERPA law, this information could include: student name, residential address, e-mail address, phone numbers, photographs/images, school locations, field of study, degrees, honors and awards received and participation in athletics and other activities.

It is the intent and practice of the School District to publish, post, or release ONLY an applicant’s name,photograph, audio and/or video recording, displays of student work or other school-related information and ONLY as related to student achievement (e.g. academic/athletic recognition or award) or student accomplishment (e.g. a specially selected piece of work).

I understand that if I do not wish to grant permission to Pasco County Schools to release my information as defined above I must complete a Media Release Form that must be completed by me, in person, at the administration office on campus*

I have read and agree to the media release terms and conditions

NOTIFICATION OF INSPECTION FOR ASBESTOS CONTAINING MATERIALS IN PUBLIC SCHOOLS

NOTICE TO BUILDING OCCUPANTS AND PARENTS

The Environmental Protection Agency (EPA) has issued a final rule, 40 CFR Part 763, Asbestos Containing Material in schools, commonly referred to as AHERA. This rule requires all Local Education Agencies (LEA’s) to identify asbestos containing materials (ACM) in their school buildings and to take appropriate actions to control the release of asbestos fibers.

All inspections for Marchman Technical College have been completed and a Management Plan describing the results of the inspection and the action plan to control any asbestos found during the inspection, where applicable, has been submitted to the governor for approval. A copy of this plan is located in the administrative office of this school and at the Pasco County Schools Maintenance & Facility Services Department and is available for review upon request.

NOTIFICATION OF INSPECTION FOR ASBESTOS CONTAINING MATERIALS IN PUBLIC SCHOOLS*

I Have Read The Above Statement

Responsible Electronic Use Guidelines for Students

I have access to the Internet, school networks and electronic devices so I can…
expand my learning;
communicate with others about what I am learning;
research topics for class projects or for my personal learning;
create products highlighting my learning;
learn how to be a responsible and productive digital citizen.

Here are some things I need to know:
Electronic devices include but are not limited to computers, netbooks, iPads, iPods, tablets, cell phones, cameras, and other electronic devices that allow me to create and communicate.
I am responsible for all my online activities that take place through the network connection with my school’s devices or through access with my own personal electronic devices.

I am responsible for obeying all laws, including copyright. This also means I may not use the District logo or other District-owned content on my personal posts.

I do not have the right of privacy when accessing the Internet or network while at school.
Communicating electronically includes using my camera and cell phone to communicate visually.
When communicating electronically, I should ask myself: Is it safe? Is it kind? Is it respectful? Is it appropriate?

I do not have an absolute right to take, publish/post photographs or videos of others at school, as it may impact their individual rights of privacy.

Bullying or harassing someone either in person or electronically is wrong, violates the Code of Student Conduct, and is against the law.
Information I find on the Internet is not necessarily true or accurate.
There are filters to prevent access to inappropriate information, but no filter is perfect. I must protect myself by knowing how to close a window or click on the back button.

I can learn more about being a responsible digital citizen at http://www.safeflorida.net/safesurf.
Here’s what I agree to do as a responsible and productive digital citizen:

I will follow all school rules and laws when using electronic devices at school.

I will not damage equipment, upload harmful files, damage files, delete files, or access someone else’s files because it impacts others.

I will keep my password to myself and will not share it with others.

I will not search for or try to access obscene, harmful, or inappropriate material.

If I accidentally access inappropriate materials, I will close the window and tell a responsible adult.

I will not post or send hurtful, offensive or inappropriate material.

I will behave honestly, fairly, and with integrity when posting online, including my social networks.

I will follow rules of network etiquette, and I will be polite when communicating with others electronically. I will not use bad language or access messages from others who use bad language.

I will not post or share pictures of others without their knowledge and approval.

I will stay safe and will never meet or give out personal information such as my name, phone number, or address to someone I meet on the Internet without the express permission of my parents and/or teachers.

I will discuss my online activities with my parents so they understand how I am learning to be a good digital citizen.

My teachers and administrators have the right to access whatever I do online while in school if they are concerned about my safety or the safety of others.

I will not use others’ work without permission or without citing their work according to copyright laws.

If I’m not sure how to do something or whether something is okay to access or do, I will ask a responsible adult.

What happens if I violate this agreement and am not a responsible digital citizen?
Violations of this agreement will result in disciplinary action according to the Code of Student Conduct.

I have read The Terms and Conditions of the Responsible Electronic Use Guidelines for Students*

I confirm that I have read and agree to the Responsible Electronic Use Guidelines for Students

Disability Disclosure

Pasco County Schools (the District) hereby stipulates and affirms its policy of offering equal educational opportunities for all persons regardless of race, color, ethnicity, religion, national origin, age, gender, marital status, disability, genetic information or legally-protected characteristic. As such, it is the policy of the District to provide reasonable substitutions for any person enrolled in a postsecondary vocational programs who is hearing impaired, visually impaired, dyslexic or who has a specific learning disability where failure to meet the requirements is related to the disability. In order to receive disability accommodations or substitution, qualifying students must provide documentation that clearly shows evidence of a disability to the Special Populations Coordinator for individual consideration. The Special Populations Coordinator may be contacted at (727) 774-1731.

Confirm That You Have Read The Disability Disclosure*

I Have Read The Disability Disclosure

Refund Policy

Full-time and half-time students qualify for a refund of tuition and fees if the student formally withdraws during the first five days of class. There will be no refund of tuition or fees beyond the first five (5) days of class. There will be no refund of fees for kits or books once they are distributed. Students withdrawing from a program within the first five days of class must complete the Request for Withdrawl form available in the Administration Office. Students are encouraged to state the reason for withdrawl.

Refunds due to course cancellation will be issued at one hundred percent (100%). Refunds, when due, are made within thirty (30) days of the last day of attendance. The refund will be made payable to the student.

Confirm that you have read and agree to the refund policy*

I have been notified of and agree to the refund policy at Fred K. Marchman Technical College

Terms and Conditions

I certify that the information on this application is correct to the best of my knowledge. By signing below I hereby agree to all the information provided and furhtermore give my permission for the use of this data included herin in managing the program for which I am registered.

Also, by submitting this application I understand that I am not guaranteed acceptance into a program.

Confirm that you have read and agree to the terms and conditions*

I have been notified of and agree to the terms and conditions at Fred K. Marchman Technical College

2025-2026 Fall Application for Acceptance into Fred K. Marchman Technical College Early Childhood Education - APPR