Work-Based Learning Universal Application
Students who are intending to sign-up for a Work-Based Learning class (SSL, Work Study or Internship) during the upcoming school year, must complete this application as soon as possible.  Failure to do so may jeopardize your placement in the program.


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First Name *
Last Name *
Current Grade *
Cell Phone *
Student email (NOT @my.FCPS EMAIL) *
Check all that apply *
Required
Please specify where you want to be placement (Teacher, Business, etc. )
This application will be reviewed to assure that you meet the participation requirements.  Those requirements are                                                                                                                                                         1)   2.75 or higher cumulative weighted GPA                                                                                                                                                                                  2)  No office referral in previous semester                                                                                                                                      3)  No more than 10 absences in the previous semester.                                                                          Please check the box below to confirm that you understand. *
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