Parent or Guardian's Contact Information
Parent or Guardian's Name:
School Identification Number (Student ID#):
In August 2016, in what grade will you be?
Country of Birth:
Language Spoken at Home:
Work Experience Information
Worksite assignment preference (City):
How do you plan to get to your worksite?
List Any Languages Other Than English You Speak:
What type of work experience would you prefer:
Select your best skill/interest:
but in some cases it may help us in matching you to a particular job. Indication
of a special skill does not guarantee a position utilizing that skill)
Select all that apply to you. Doing so will help us to match you to work experience suitable to your unique needs and background.
(We will ask for verification)
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