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 *
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?
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.
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