St. Bede High School
Counselor--Name of counselor making recommendation
Select Home School Of Student Entering
Class Next Year
Select the Class to Enroll In (If your school has allowed you to enroll in two classes, you will need to submit two forms).
Auto Technology I
Auto Technology II
Building Trades I
Building Trades II
Child Care I
Child Care II
Computer Aided Drafting I
Computer Aided Drafting II
Computer Repair (1st Semester)
Intro to Programming/Database (Second Semester)
Computer Repair & Intro to Programming(1 Year)
Cosmetology (Seniors Only)
Residential Wiring I
Residential Wiring II
Basic Fire Skills I
Basic Fire Skills II
Health Occupations I (5 remaining)
Health Occupations II (5 remaining)
Machine Technology I (5 remaining)
Machine Technology II (5 remaining)
Welding I (5 remaining)
Welding II (5 remaining)
IVEO I--Entrepreneurship (5 remaining)
Transitional Math (1 Semester--Fall or Spring)
Did Student Attend ACC Last Year?
Student SIS#(Get this number form your counselor)
Please enter a working email address where the finished registration form can be sent. This form will need to be signed and returned to the student's counselor at his/her home school.
Re-enter email address
Student First Name
Student Last Name
Is it acceptable to photograph this student?
List any Physical or Medical Conditions to be aware of (Enter N/A if there are none). Click + after each condition entered, to add multiple conditions.
Primary Physicians Name
Physicians Phone Number
Secondary Physicians Name
Physicians Phone Number
In case of emergency; what hospital should student be sent to?
Contact Person: (Enter Full Name, Relationship, and Primary Phone Number). To list multiple people, press the + symbol after each person entered.
As a part of the standard ACC curriculum your child will attend field sessions that take him or her outside of the Area Career Center. These field sessions will take place within the immediate Illinois Valley area. By checking this box you consent to your child's involvement in these field sessions. Any field trip that goes outside of the Illinois Valley Area will require your child to bring home a formal field trip permission slip. Checking this box affirms your consent on an ongoing basis for the routine field experiences within the Illinois Valley and foregoes the necessity of a formal field trip form being sent home.
The LaSalle Peru Area Career Center operates on a limited enrollment basis. This means that each class has a certain number of reserved seats. When a student accepts enrollment in an ACC class there may be additional students who are on a waiting list to get into that class. For this reason the ACC has a strict 10 day absence limit. Any student who exceeds the 10 day unexcused absence limit will be recommended for enrollment in an attendance remediation program at the ACC. By checking the box below you are indicating that you have read this clause and understand its ramifications as it pertains to maintaining enrollment in the ACC. Failing to check this box will cause the form to be returned to the parent and student and could jeopardize enrollment in the LPACC.
Is this student required to be on an asthma plan? (If so, the ACC will need to have a copy of that plan on file, check N/A for non-asthmatic children)
Parent or Guardian Signature (Print form that is emailed to you[or your child] and then sign ). Please sign printed form in ink, even if you sign using the electronic box.