Work Based Learning Application Fall 2021
You will need to use your CCBOE email to fill out this form....This is the first part of the enrollment process. A Training Agreement and 3 Teacher Recommendation Forms (You can pick these up at CATA or from your counsellor) will need to be completed, signed, and turned in to the WBL Coordinator, Mr. Riddle. Thank you
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Are you considered 'on track' to graduate with your Senior Class? (Grades, Attendance, Discipline) *
What is your STUDENT Email? (1908765432@ccboe.org) *
Do you have access to internet and a device outside of school? (All course work is completed online via Google Classroom and Canvas) *
First Name (please give your legal name) *
Last Name *
School *
Grade *
Your Cell Number (xxx-xxx-xxxx) *
Parent/ Guardian name *
Parent/Guardian Phone Number *
What is your Career Objective Pathway *
Name of Training Station (Where you work) *
Training Station Address *
Supervisor Name *
Supervisor Phone Number *
Supervisor Email *
How long have you worked here? *
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