2022-2023 NCCA WBL Interest Form
2022-2023 NCCA Work-Based Learning Pre-Application / Interest form. Completing this form DOES NOT automatically enroll you in WBL. Your WBL coordinator will contact you if you meet all requirements.
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Email *
Last Name: *
First Name: *
Grade this school year: (Junior or Senior?) *
What is your base school?
Clear selection
What is your Career Pathway 1? (Example: culinary, marketing, healthcare, etc...) *
What is your email address? Input your personal email NOT the newtonstudents.org email address please. *
What is your Career Pathway 2? Leave blank if you're enrolled in only 1 pathway.
What is your career goal when you finish school? Ex: nurse, engineer, lineman, daycare owner, etc.
Who is your counselor?
Clear selection
What is your cell phone number? *
Do you have a job now? *
If you have a job, list the name and location of the company.
List your extra-curricular activities for next school year. (Sports, band, volunteer work, etc.)
Will you have a car or reliable transportation to get to work this school year? *
Is your overall GPA 80% or above? *
Do you have acceptable attendance from last school year? *
Submit
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