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Carver High School Work-Based Learning Program Application
If you are interested in Work-Based Learning for the 2021-2022 school year, please complete this information.
NOTE: Completing this Interest Form does NOT guarantee admittance into the Work Based Learning Program.
(2 classes = 15-hour per week work requirement).
Requirements for admission to WBL program:
High school senior in 2021-2022
Enrolled in or completion of a pathway class related to the job placement
Favorable behavior record (no discipline issues)
No more than 10 absences and tardies during 2020-2021
Cumulative Average 75 or above
On track for graduation (sufficient number of credit classes)
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* Indicates required question
Student Full Name
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Your answer
Student GTID
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Your answer
Student Age
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Your answer
Student Birthday
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MM
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DD
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YYYY
Student Address
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Your answer
Student Cell Phone
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Your answer
Student Email
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Your answer
Do you have transportation to work?
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Yes
No
Driver's License Number
Your answer
Parent/Guardian Name
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Your answer
Parent/Guardian Occupation
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Your answer
Parent/Guardian Phone Number
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Your answer
Parent/Guardian Email
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Your answer
Current GPA
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Your answer
Number of Discipline Referrals last year (2019-2020)
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Your answer
Number of Absences last year (2019-2020)
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Your answer
Number of Tardies last year (2019-2020)
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Your answer
List any school/community service activities from the last 3 years.
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Your answer
Career/CTAE Pathway(s) studied
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Your answer
Are you a member of a CTSO?
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Yes
No
If yes, which CTSO?
FBLA
DECA
FCCLA
HOSA
TSA
SkillsUSA
Clear selection
Have you completed at least 2 classes in your chosen CTAE pathway?
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Yes
No
List completed pathway classes:
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Your answer
What are you post-secondary plans?
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College/University
Technical School
Military
Workforce
What is your Career Goal?
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Your answer
Are you currently employed?
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Yes
No
If yes, where are you currently employed (be specific)?
Your answer
How many hours do you work per week?
Your answer
What is your current wage?
Your answer
When did you start this job?
MM
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DD
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YYYY
Do you plan to keep this job for the entire school year?
Yes
No
Clear selection
Job description and duties:
Your answer
Previous work experience and employer information:
Your answer
Are you involved in any activities that will interfere with your work hours? (Music and Drama Troupe, caring for a child, sports, cheerleading, school or community activities, second part-time job, etc.) (Please answer this truthfully.)
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Your answer
Explain why you want to participate in the work based learning program.
Your answer
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