Carver High School Work-Based Learning Interest Form
If you are interested in Work-Based Learning for the 2020-2021 school year, please complete this information by August 14, 2021.
NOTE: Completing this Interest Form does NOT guarantee admittance into the Work Based Learning Program.
Student Full Name *
Student GTID *
Student Age *
Student Birthday *
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Student Address *
Student Cell Phone *
Student Email *
Do you have transportation to work? *
Driver's License Number
Parent/Guardian Name *
Parent/Guardian Occupation *
Parent/Guardian Phone Number *
Parent/Guardian Email *
Current GPA *
Number of Discipline Referrals last year (2019-2020) *
Number of Absences last year (2019-2020) *
Number of Tardies last year (2019-2020) *
List any school/community service activities from the last 3 years. *
Career/CTAE Pathway(s) studied *
Are you a member of a CTSO? *
If yes, which CTSO?
Clear selection
Have you completed at least 2 classes in your chosen CTAE pathway? *
List completed pathway classes: *
What is your Career Goal? *
Are you currently employed? *
If yes, where are you currently employed (be specific)?
How many hours do you work per week?
What is your current wage?
When did you start this job?
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DD
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Do you plan to keep this job for the entire school year?
Clear selection
Job description and duties:
Previous work experience and employer information:
Explain why you want to participate in the work based learning program.
Submit
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