* indicates required field Applicant Information Please enable JavaScript in your browser to complete this form.Name *FirstLastHome Street Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePrimary Phone *Secondary PhonePrimary Email *Secondary EmailDo you currently receive income (full-time or part-time) from Penn State University? *YesNo(Individuals that receive income from Penn State University are NOT eligible to receive a stipend for this project) Select the school for which you are a current and active Occupational Advisory Committee Member *Select school…A W Beattie Career CenterAcademy at WestinghouseAdmiral Peary AVTSAllderdice High SchoolAltoona Area High SchoolAthens Area High SchoolBald Eagle Area Jr./Sr. High SchoolBangor Area High SchoolBeaver County Career & Technology CenterBedford County Technical CenterBellefonte Area High SchoolBellwood-Antis High SchoolBenton Area Middle Senior High SchoolBerks Career and Technology Center – EastBerks Career and Technology Center – WestBerlin Brothersvalley Senior High SchoolBermudian Springs High SchoolBerwick Area High SchoolBethlehem AVTSBig Spring High SchoolBiglerville High SchoolBradford Area High SchoolBrashear High SchoolBrockway Area Jr./Sr. High SchoolBucks County Technical High SchoolButler County AVTSCanton Jr./Sr. High SchoolCarbon Career and Technical InstituteCareer Institute of TechnologyCarlisle Area High SchoolCarrick High SchoolCarver High School For Engineering & ScienceCedar Crest High SchoolCentral Career and Technical SchoolCentral Columbia Senior High SchoolCentral High SchoolCentral Montco Technical High SchoolCentral PA Institute for Science & TechnologyCentral Westmoreland Career & Technology CenterChambersburg Area Senior High SchoolChartiers Valley High SchoolChester County Technical College HS – PickeringChester County Technical College HS- BrandywineChester County Technical College HS- Pennocks BrChester High SchoolChestnut Ridge Senior High SchoolClarion County Career CenterClarion-Limestone Area Jr./Sr. High SchoolClearfield Area High SchoolClearfield County Career & Technology CenterColumbia-Montour AVTSConneaut Area Senior High SchoolConnellsville Area Career & Technical CenterCorry Area High SchoolCoudersport Area Jr./Sr. High SchoolCowanesque Valley Jr./Sr. High SchoolCrawford County Career & Technical CenterCreative and Performing ArtsCTC of Lackawanna CountyCumberland Perry AVTSCumberland Valley High SchoolDanville Area Senior High SchoolDauphin County Technical SchoolDelaware County Technical High School – AstonDelaware County Technical High School – FolcroftDelaware County Technical High School – MarpleDelaware Valley High SchoolDerry Area Senior High SchoolDobbins AVT HSDover Area High SchoolEast Juniata Jr./Sr. High SchoolEastern Center for Arts & TechnologyEastern Lebanon County Senior High SchoolEastern Westmoreland Career & Technology CenterEaston Area High SchoolEdison High School/Fareira SkillsElizabethtown Area Senior High SchoolEphrata Senior High SchoolErie County Technical SchoolFairfield Area High SchoolFayette County Career & Technical InstituteFels Samuel High SchoolForbes Road Career & Technology CenterFort Cherry Jr./Sr. High SchoolFrankford High SchoolFranklin County Career & Technology CenterFranklin Learning CenterFulton County AVTSGarden Spot Senior High SchoolGeorge Jr Republic High SchoolGettysburg Area High SchoolGreater Altoona Career & Technology CenterGreater Johnstown Career & Technology CenterGreater Johnstown Senior High SchoolGreene County Career & Technology CenterGreenwood High SchoolHazleton Area Career CenterHonesdale High SchoolHuntingdon County Career & Technology CenterIndiana County Technology CenterJefferson County-DuBois AVTSJersey Shore Senior High SchoolJohn Bartram High SchoolJohnsonburg Area High SchoolJuniata Senior High SchoolJuniata Valley Jr./Sr. High SchoolKennard-Dale High SchoolKensington CAPAKensington Health Science AcademyKensington International Business HSKeystone Central Career & Technology CenterKing Martin Luther High SchoolKutztown Area Senior High SchoolLampeter-Strasburg Senior High SchoolLancaster County CTC – BrownstownLancaster County CTC – Mount JoyLancaster County CTC – Willow StreetLaurel Jr./Sr. High SchoolLawrence County Career & Technology CenterLebanon County Career & Technology CenterLehigh Career & Technical InstituteLenape Technical SchoolLiberty Jr/Sr High SchoolLincoln High SchoolLine Mountain Jr./Sr. High SchoolLittlestown Senior High SchoolLycoming Career & Technology CenterManheim Central Senior High SchoolMansfield Jr/Sr High SchoolMarion Center Area High SchoolMastbaum Jules E AVTSMcCaskey CampusMcGuffey High SchoolMcKeesport Area Technology CenterMercer County Career CenterMeyersdale Area High SchoolMiddle Bucks Institute of TechnologyMidd-West High SchoolMifflin County Academy of Science and TechnologyMifflinburg Area Senior High SchoolMilton High SchoolMohawk Jr./Sr. High SchoolMon Valley Career & Technology CenterMoniteau Jr./Sr. High SchoolMonroe Career & Technical InstituteMontgomery Senior High SchoolMount Union Area Senior High SchoolNorth Montco Technical Career CenterNorth Penn Jr/Sr High SchoolNortheast High SchoolNorthern Bedford County MS/SHSNorthern High SchoolNorthern Lebanon Senior High SchoolNorthern Potter Jr./Sr. High SchoolNorthern Tier Career CenterNorthern Westmoreland Career & Technology CenterNorthumberland County Career & Technology CenterNorthwest Area High SchoolNorthwestern Senior High SchoolOctorara Area High SchoolOley Valley Senior High SchoolOverbrook High SchoolParkway West Career & Technology CenterPaul Robeson High School for Human ServicesPenn Manor High SchoolPenn Treaty SchoolPennridge High SchoolPenns Manor Area Jr./Sr. High SchoolPequea Valley High SchoolPerry Traditional AcademyPottstown Senior High SchoolRandolph, Philip A. AVT HSReading-Muhlenberg Career and Technology CenterRed Lion Area Senior High SchoolRoxborough High SchoolSaint Marys Area Senior High SchoolSalisbury-Elk Lick Jr./Sr. High SchoolSaul W B Agricultural SchoolSchuylkill Technology Center – NorthSchuylkill Technology Center – SouthSelinsgrove Area High SchoolSeneca Highlands Career and Technical CenterSolanco High SchoolSomerset Area Senior High SchoolSomerset County Technology CenterSouth Philadelphia High SchoolSouthern Huntingdon County HS/MSState College Area High SchoolSteel Center AVTSSUN Area Technical InstituteSusquehanna County Career & Technology CenterSwenson Arts and Technology High SchoolThe Workshop High SchoolTitusville Senior High SchoolTri-Valley Jr./Sr. High SchoolTroy Area Senior High SchoolTulpehocken Jr./Sr. High SchoolTunkhannock High SchoolTussey Mountain Jr./Sr. High SchoolTyrone Area High SchoolUnited Jr./Sr. High SchoolUniversal Audenried Charter High SchoolUpper Bucks County Technical SchoolUpper Dauphin Area High SchoolVenango Technology CenterWallenpaupack Area High SchoolWarren County AVTSWashington George High SchoolWaynesburg Central High SchoolWellsboro Area High SchoolWest Perry Senior High SchoolWest Philadelphia High SchoolWest Side Career & Technology CenterWestern Area Career & Technology CenterWestern Montgomery Career and Technology CenterWilkes-Barre Career and Technical CenterWilliamsburg Community Jr./Sr. High SchoolWilliamsport Area Senior High SchoolWilmington Area High SchoolYork County School of TechnologyAre you currently an instructor at this or another school? *YesNoIf yes, which program?List the program for which you are a current and active Occupational Advisory Committee Member *Select program…Accounting Technology/Technician and Bookkeeping (52.0302)Administrative Assistant and Secretarial Science, General (52.0401)Agricultural & Food Products Processing (01.0401)Agricultural Mechanization, General (01.0201)Agricultural Production Operations, General (01.0301)Agriculture, Agriculture Operations and Related Sciences, Other (01.9999)Agriculture, General (01.0000)Animal Science, General (01.0901)Apparel and Textile Marketing Management (19.0905)Appliance Installation and Repair Technology/Technician (47.0106)Applied Horticulture/Horticultural Operations, General (01.0601)Architectural Drafting and Architectural Drafting CAD/CADD (15.1303)Autobody/Collision and Repair Technology/Technician (47.0603)Automobile/Automotive Mechanics Technology/Technician (47.0604)Baking and Pastry Arts/Baker/Pastry Chef (12.0501)Barbering/Barber (12.0402)Biotechnology (26.1201)Building/Property Maintenance and Manager (46.0401)Cabinetmaking and Millwork/Millwright (48.0703)Carpentry/Carpenter (46.0201)Child Care and Support Services Management (19.0708)Cinematography and Film/Video Production (50.0602)Civil Drafting & Civil Engineering CAD/CADD (15.1304)Commercial and Advertising Art (50.0402)Commercial Photography (50.0406)Communications Technologies (10.9999)Computer Programming/Programmer, General (11.0201)Computer Systems Networking and Telecommunications (11.0901)Computer Technology/Computer Systems Technology (15.1202)Construction Trades, Other (46.9999)Construction/Heavy Equipment/Earthmoving Equipment Operation (49.0202)Cosmetology/Cosmetologist, General (12.0401)Criminal Justice/Police Science (43.0107)Dental Assisting/Assistant (51.0601)Digital Communications & Media/Multimedia (09.0702)Drafting and Design Technology/Technician, General (15.1301)Electrical and Electronic Engineering Technologies/Technicians, Other (15.0399)Electrical and Power Transmission Installers, Other (46.0399)Electrical, Electronic and Communications Engineering Technology/Technician (15.0303)Electrical, Electronics Maintenance and Repair Technology, Other (47.0199)Electromechanical Technology/Electromechanical Engineering Technology (15.0403)Emergency Medical Technology/Technician (51.0904)Engineering Technologies/Technicians, Other (15.9999)Entrepreneurship/Entrepreneurial Studies (52.0701)Family & Consumer Sciences/Human Sciences, General (19.0101)Family & Consumer Sciences/Human Sciences, Other (19.9999)Fire Science/Fire-Fighting (43.0203)Forestry Technology/Technician (03.0511)General Office Occupations and Clerical Services (52.0408)Graphic Communications, Other (10.0399)Health Information/Medical Records Technology/Technician (51.0707)Health Care Technology (51.9999)Health/Medical Assisting Services, Other (51.0899)Heating, Air Conditioning, Ventilation and Refrigeration Maintenance Technology (47.0201)Heavy Equipment Maintenance Technology/Technician (47.0302)Housing & Human Environments, Other (19.0699)Human Development, Family Studies & Related Services, Other (19.0799)Industrial Mechanics and Maintenance Technology (47.0303)Institutional Food Workers (12.0508)Job-Seeking/Changing Skills (Diversified Occupations) (32.0105)Lineworker (46.0303)Logistics and Materials Management (52.0203)Machine Tool Technology/Machinist (48.0501)Management Information Systems, General (52.1201)Mason/Masonry (46.0101)Meat Cutting/Meat Cutter (12.0506)Medical/Clinical Assistant (51.0801)Medium/Heavy Vehicle and Truck Technology/Technician (47.0613)Natural Resources Management & Policy, Other (03.0299)Nurse/Nursing Assistant/Aide and Patient Care Assistant (51.3902)Painting/Painter and Wall Coverer (46.0408)Plumbing Technology/Plumber (46.0503)Precision Metal Working, Other (48.0599)Precision Production, Other (48.9999)Sales, Distribution and Marketing Operations, General (52.1801)Security & Loss Prevention Services (43.0109)Homeland Security, Law Enforcement, Firefighting and Related Protective Services, Other (43.9999)Sheet Metal Technology/Sheetworking (48.0506)Tourism and Travel Services Marketing Operations (52.1905)Vehicle & Vehicle Parts & Accessories Marketing Operations (52.1907)Vehicle Maintenance & Repair Technologies, Other (47.0699)Veterinary/Animal Health Technology/Technician & Veterinary Assistant (51.0808)Web Page, Digital/Multimedia and Information Resources Design (11.0801)Welding Technology/Welder (48.0508)Well Drilling/Driller (46.0504) (An active OAC member has served and attended regular school meetings for at least three years) Do you hire Co-Op students from local career and technical education programs? *YesNoAttach current resume or email the file to testing@careertechpa.org Click or drag a file to this area to upload. I agree to the terms of the Pennsylvania Cut Score Development Security/Confidentiality Statement. *SECURITY/CONFIDENTIALITY STATEMENT All documents and information involved in the Pennsylvania Cut Score Development, including assessment review are to be held in absolute confidentiality. Test material, drafts, notes, performance jobs, evaluation criteria, or any other aspect of the Pennsylvania Cut Score Development content are NOT to be shared, copied, or used in any manner outside the scope of the actual project. In addition, all documents and information will be deleted from computers and other electronic devices. To complete your application, please check both statements below.I understand that, if chosen, I am committing myself to participate in all activities related to this Pennsylvania Cut Score Development process including the mandatory training session. *Submit Share this:FacebookX