Manchester Craftsmen's Guild: Apprenticeship Training Program

Revised
2/3/12
Manchester Craftsmen’s Guild: Apprenticeship Training Program
Returning CYF Student Enrollment Forms, Spring 2012
© 2012 Manchester Craftsmen’s Guild, a subsidiary of Manchester Bidwell Corporation Page 1 / 2
Referrals to this program should be submitted to Kat Gregor no later than March 9, 2012. Applications will be
approved after confirming with Renee Cook of ACDHS. Referrals after this date will be put on the waitlist and
will be informed of acceptance if there is room in the course after March 15, 2012.
Courses run March 19, 2012 – June 1, 2012
Return completed
forms to:
Kat Gregor
Manchester Craftsmen’s Guild
1815 Metropolitan Street
Pittsburgh, PA 15233
(412) 322-1773 ext. 196
Fax (412) 321-2120
kgregor@mcg-btc.org
Spring 2012 Course Selection
Students may enroll in one course, and are required to attend on Fridays for open studios, unless they gain
special approval from Kat Gregor. Only returning students with good attendance records (70% or higher) are
eligible to enroll in two courses. Approval for two courses must be gained from Kat Gregor prior to student
attending program.
Each studio has a different course Monday to Thursday. Course descriptions can be found at:
http://mcgyouthandarts.org/atp
Please write the student’s first choice and alternate course selection below. First choice courses are not
guaranteed. Alternate course will be selected for the student if their first choice is full. Please circle the day of
the course and studio and write the course title below. This is to make sure students are enrolled in the
correct course.
First Choice Selection
Day: Mon Tues Wed Thurs Studio: Ceramics Design Digital Photo
Course Name:
Alternate Choice Selection
Day: Mon Tues Wed Thurs Studio: Ceramics Design Digital Photo
Course Name:
Last Name:
First Name:
Birth Date: Gender: Female Male
Ethnicity
African-American Asian Caucasian Hispanic Multi-Racial
(check one):
No Response
Other:
School Attending in 2011-12: Grade Level: Graduation Year:
My school provides me with a public bus pass: Yes No
Student is Eligible for (check one): Free Lunch Reduced Lunch Neither Free nor Reduced Lunch
© 2012 Manchester Craftsmen’s Guild, a subsidiary of Manchester Bidwell Corporation
Manchester Craftsmen’s Guild admits students of any race, color, and national or ethnic origin.

Revised
2/3/12
Manchester Craftsmen’s Guild: Apprenticeship Training Program
Returning CYF Student Enrollment Forms, Spring 2012
© 2012 Manchester Craftsmen’s Guild, a subsidiary of Manchester Bidwell Corporation Page 2 / 2
Student Contact Information
My contact information has not changed since last trimester (Winter 2012)
Street Address
City State Zip Code Student Phone:
Guardian Information
My guardian’s information has not changed since last trimester (Winter 2012)
Check one: Parent / Legal Guardian’s Home Foster Home Residential / Group Home
Name of Home or Agency:
Last Name:
First Name:
Street Address:
City: State: Zip Code:
Phone:
Alternative Phone:
CYF Caseworker / Probation Officer Information
Student does not have a Caseworker or Probation Officer
Student’s Caseworker or Probation Officer information has not changed since last trimester (Winter 2012)
Caseworker / Probation
Officer Name:
Caseworker / Probation
Officer Phone:
CYF
Caseworker’s
Regional
Office:
ADOPT CRO ERO FC
LIO MVRO NRO SRO
End-of-Day Student Transportation Method
At 5:30 p.m., CYF students will journey home in one of two ways – Provider Pick-up or Public Bus.
Select student’s mode of transportation below:
Student will be picked up promptly by provider, who will come inside, show ID to MCG staff and sign out the student.
Student will travel home using public buses. Documentation granting student permission to travel home on public buses is
attached to this application is the form of (select one):
a goal in the student’s ISP (ISP must be attached)
a letter granting permission from the provider or CYF caseworker on letterhead
letter from a parent/ guardian if student resides with parent/ guardian
Student Medical History
If medical information needs updated, please contact Kat Gregor, Student Services, at (412) 322-1773 ext. 196 or
kgregor@mcg-btc.org. MCG does not have any medical staff but will make every effort to reach emergency contacts and
get immediate medical attention if need be.
© 2012 Manchester Craftsmen’s Guild, a subsidiary of Manchester Bidwell Corporation
Manchester Craftsmen’s Guild admits students of any race, color, and national or ethnic origin.