MI Bright Future Career Coach Registration Form
PLEASE NOTE: Registrations submitted after May 14 may be delayed due to staffing constraints over the summer. Full-time registration processing will recommence Fall 2019 as students resume system activity. If you have any questions or concerns about your registration, please contact us at info@mibrightfuture.org.

Thank you for registering to be a MI Bright Future Career Coach! Safety of students using MI Bright Future is always a top priority, so any and all users interacting with students are required to pass a criminal history background check before using the system. Because Career Coaching consists of direct communication with students, by completing this form, and agreeing to the “Terms and Conditions” below, you give your authorization for MI Bright Future to conduct a background check. To view MI Bright Future’s policy and procedures governing volunteer criminal history, visit http://goo.gl/kVfd9r.

If you are approved to volunteer following the background check, MI Bright Future will build your profile in the system using the information you provide in this form. The submission of this form is also considered to be your consent to have your profile activated for student access. When your profile is ready, you will receive an email notification with log in instructions.

If you are interested in finding out more about MI Bright Future, including all of the great features your company can have access to by registering, please view our tutorial video (goo.gl/kDohNt).

If you have any immediate questions, please contact us at the email address below.

Regards,
MI Bright Future team

info@mibrightfuture.org
Contact First Name *
Contact Middle Name *
Please provide your FULL middle name - not just the middle initial. This is needed for the background check. If you do not have a middle name, type "no middle name".
Contact Last Name *
Contact Date of Birth *
mm/dd/yyyy
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Contact Gender *
This information is collected for the express purpose of performing the background check. Please select the gender with which you most closely identify.
Contact Ethnicity *
This information is collected for the express purpose of performing the background check, and will not be used to determine eligibility or participation in this program.
Contact Email Address *
Re-enter Email Address *
Contact Phone Number *
Current Company *
If you are retired, or currently unaffiliated with a company, please indicate so by entering, "Retired" or "Unaffiliated".
Contact Title or Position *
County in which you primarily do business
Joining a previously registered MI Bright Future company profile? *
If you are joining your company's profile as an additional contact, please mark "Yes"
If joining an existing profile, would you like to answer questions about your company through a company discussion board?
Clear selection
How did you hear about us? *
Please check all that apply.
Required
What careers would you like to serve in as a Career Coach? List all that apply. *
Typically these are careers that you have experience in. Your current profession, and any previous jobs you have had, are ideal. Note: Please try to be as general as possible. For example, put "Electrical Engineer," and not "Electronics Specialist."
Select all of the work-based learning activities you would like to offer:
Check all that apply. Remember, you can adjust activities you offer any time you wish by logging in to your profile!
Additional company contact activities:
Joining a previously registered MI Bright Future company? Select any additional work-based learning activities you would like to offer. PLEASE NOTE: if you marked 'no' to joining an existing company profile above, you cannot be enrolled in any of the activities listed below.
I understand the work-based learning activities I offer will be primarily accessed by high school students (15-18 years old).
Clear selection
Career Path History
Please provide a brief description of how you came to work in your current profession.
Former Companies *
Please indicate what other companies you have worked for. If none, enter "N/A".
Other Jobs You've Had *
If none, enter "N/A".
Association Memberships *
If none, enter "N/A".
Hobbies and Interests *
Terms and Conditions *
MI Bright Future makes it possible for students/career seekers to explore careers with guidance from professionals and employers. A 10-year criminal history background check is required when a volunteer indicates an interest in activities requiring student interaction. Activities requiring student interaction include, but are not limited to, career coaching, work-based learning activities, company message board access, and student messaging. Background checks are of vital importance to MI Bright Future because volunteers are likely to have direct, ongoing contact with children. By completing and submitting this form and agreeing to this authorization, you give your authorization for MI Bright Future to conduct a background check. This background check includes reviewing state and national criminal and sexual offense registries. This authorization shall remain on file and shall serve as an ongoing authorization for MI Bright Future to conduct additional background checks during your time as a volunteer. You agree to abide by these Terms and Conditions. You understand that, if approved to volunteer following the background check, your indication on this form of willingness to participate in work-based learning activities, and your subsequent approval of a student’s request for these activities, is considered by MI Bright Future to be your consent to release your contact information to the student making the request, and the appropriate school administrator necessary for arranging the activity. Absent your personal approval of a work-based learning activity request made by a student, you shall only be identified in the MI Bright Future system as the nickname you provide. Broadcast messages sent by a Company Contact will be visible to users once approved by a MI Bright Future administrator. All discussions and postings are public and can be viewed by any and all MI Bright Future users and administrators. Any inappropriate postings should be reported using the "flag inappropriate posting" box. Career Coaches and Company Contacts are not to communicate or meet with any student outside of the MI Bright Future web portal without permission from the student's parent(s)/guardians/family. You must comply with all school and local requirements relative to meeting or work activities involving students, and abide by all Michigan state laws. All parties involved understand that any information given is personal experience or opinion and is not meant to exclude exploration of any other career possibilities or guarantee a specific outcome. You hereby release the Southeast Michigan Community Alliance, Inc., the Workforce Intelligence Network for Southeast Michigan, MI Bright Future, and their Boards, Officers, Employees, Member Communities, Representatives, and Agents from any liability which may or could result from furnishing the information requested above or from any subsequent use of such information in determining eligibility for volunteering with MI Bright Future or arising in any way from participation in the program. If you have questions regarding volunteering with MI Bright Future, please contact us at: info@mibrightfuture.org.
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