Co-Op Application 21-22

Please visit http://inspirewi.org/participating-companies/ for SPECIFIC information about the hours for each company as well as the co-op description.
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Student Name (First and Last) *
What High School do you attend? *
Student Email Address *
Student Home Address *
Student Phone Number *
Preferred method of contact *
Required
Current Grade Level (2021-22) *
What Quarter(s) are you interested in applying for this Youth Co-op experience? *
Required
Do you require a semester long placement due to your school schedule? *
What hours are you available during the week to work? (*Note: Most positions require 2 hours/day + TRAVEL TIME to and from the workplace.)
Age *
Required
Student Birthdate *
MM
/
DD
/
YYYY
Gender *
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