STEPHENSON HIGH SCHOOL WORK-BASED LEARNING PROGRAM APPLICATION 2021-2022
Please complete this WBL Student Application Form BY MARCH 1ST. *Final approval is pending completion of this application, a Teacher Recommendation from your CTAE Pathway or Humanities Teacher and one additional teacher, verification of your Attendance and Disciplinary histories, and verification by your counselor. Upon final approval, you will be notified by Mrs. Anderson.
DEADLINE TO SUBMIT IS 4PM MARCH 1, 2021
Student Number (without the "s")
YOUR cell Phone Number
YOUR Email Address
Parent/Guardian's cell phone number? XXX-XXX-XXXX
Select your grade for 2021-22
Senior (12th grade, Class of 2022)
Junior (11th grade, Class of 2023)
Select your Counselor
Select your COMPLETED CTAE or HUMANITIES/FINE ARTS Pathway
Audio & Video/ Mr. Gibbs
Band or Chorus/Mr. Goins or Mr. Johnson
Computer Science/Ms. Wall
Dance or Drama
Fashion or Sports Marketing/Dr. Jackson or Mr. Davis
Information Technology (Web Design)/Ms. Wall
Visual Arts/Ms. Murray-Kettle
World Languages-Spanish (Completed 3 years or more)
World Languages-French (Completed 3 years or more)
Besides your Pathway teacher, what other teacher would you like to complete a Teacher Recommendation for you?
What school athletics/activities do you participate in and what days do you have practice/meets/games/meetings?
Which block(s) would you like WBL?
1st Block Only (work 10 hours/week)
4th Block Only (work 10 hours/week)
1st & 2nd Blocks (work 15 hours/week)
3rd & 4th Blocks (work 15 hours/week)
1st - 3rd Blocks (work 20 hours/week)
2nd - 4th Blocks (work 20 hours/week)
Are you currently employed?
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