NMHS 2019-2020 Work-Based Learning Application
Please complete the following application to be considered for the WBL Program for the 2019-2020 school year.  

Please keep the following general information in mind before applying.
- You will need transportation available to leave campus.  Either you drive, or have a ride pick you up.  Staying on campus is NOT an option.

- You can take WBL ANY period! Ex. You could have WBL 1st and come to school for your afternoon classes or have WBL 4th and leave school early.

- If you don't have a job, start looking NOW! I will be flexible the first 2 weeks of school if you are not employed, but after that point we will have to make a class change.

- Understand that you do not have to work DURING your WBL period.  I calculate your total hours of work, not when you work. You have to work 7.5 hrs a week per period of WBL - 1 pd = 7.5 hrs/week, 2 pds = 15 hrs/week, 3pds = 22.5 hrs/week

- NO on-campus internships will be available (Ex. Office Aids, Teacher Assistants)

- You do have ASSIGNMENTS for WBL!  Your grade is based upon job performance, assignments and wage/hour reports.

- The first three days of school next year, you will NOT leave campus early.  We will need in Room A2100 to discuss the program.  

You will receive a letter telling you if you were accepted into the WBL Program.

If you have any questions please see Mrs. Lester in Room A2100 or email her at whitney.lester@dcssga.org.  Thanks!
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Email *
Last Name *
First Name *
Current Grade *
(Grade for the 2018-2019 School Year)
Street Address *
City *
Zip Code *
Your Email Address *
(Make sure this is a correct email address that you check so you will receive the information that you need.)
Mother/Guardians Name *
(First and Last Name)
Father/Guardians Name *
(First and Last Name)
Mother/Guardians Phone Number *
Father/Guardians Phone Number *
Mother/Guardian's Email Address *
Father/Guardian's Email Address *
Are you presently employed? *
If you are employed, what is the Name of your Employer (Business Name)?
If you are employed, what is your employers phone number?
If you are employed, what is your employers address?
If you are employed, what is your supervisors name?
If you are employed, what is your rate of pay?
Please list your previous work experience (starting with the most recent and working backward) *
If you are NOT employed, are you currently looking for employment?
Clear selection
If you are NOT employed, where have you applied in the last 30 days?
If you are accepted into the Work-Based Learning Program, will you have transportation to leave school? *
What is your overall grade point average? *
What period would you like to have work-based learning? *
(Check all that apply)
List three teachers who are familiar with your scholastic and work performance that you would ask to recommend you for the work-based learning program: *
Number of days absent from school during the 2018-2019 school year: *
If you had more than 6 absents, explain why:
Why do you want to participate in the work-based learning program? *
What kind of career do you envision for yourself in the future? *
What are your plans after high school? *
Are you a member of any of the following CTAE student organizations? *
List any special skills that you can bring to a company that chooses to hire you as a result of participation in this program.  In addition, describe the benefits that you expect to gain for yourself, if selected. *
I certify that I have completed the above application form after careful consideration.  If I am accepted for this work-based learning program, I will take advantage of every opportunity to improve my skills and efficiency in the classroom and the world of work.  I agree to abide by all rules, regulations and guidelines of the work-based learning program. *
(Type your name)
If accepted into the WBL Program, I understand that I  must report to the WBL Coordinator during the first three days of the semester for WBL Orientation and I may NOT leave campus. *
(Type your name)
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