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Co-Op Application 21-22
Please visit
http://inspirewi.org/participating-companies/
for SPECIFIC information about the hours for each company as well as the co-op description.
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* Indicates required question
Student Name (First and Last)
*
Your answer
What High School do you attend?
*
Choose
Cedar Grove-Belgium High School
Central High School
CHANGE Academy
Elkhart Lake-Glenbuelah High School
The Etude School
George Warriner High School
Howards Grove High School
Kiel High School
Kohler High School
Northern Ozaukee High School
Oostburg High School
Plymouth High School
Port Washington High School
Random Lake High School
Sheboygan Christian
Sheboygan Falls High School
Sheboygan North High School
Sheboygan South High School
Other
Student Email Address
*
Your answer
Student Home Address
*
Your answer
Student Phone Number
*
Your answer
Preferred method of contact
*
Email (listed above)
Phone Call (number listed above)
Text (number listed above)
Required
Current Grade Level (2021-22)
*
9th
10th
11th
12th
What Quarter(s) are you interested in applying for this Youth Co-op experience?
*
Quarter 2
Quarter 3
Quarter 4
Summer 2022
Quarter 1 2022
Required
Do you require a semester long placement due to your school schedule?
*
Yes
No
Don't know
What hours are you available during the week to work? (*Note: Most positions require 2 hours/day + TRAVEL TIME to and from the workplace.)
Your answer
Age
*
15
16
17
18
Required
Student Birthdate
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Other:
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