Enter YOUR First name

Enter YOUR last name.

Identify YOUR best contact number. Enter number with no dashes (5555555555).

I will be in the ??? grade for the 2022-2023 school year. Select ONLY ONE. Special requirements for 10th grade students!

Pathways must be in a CTAE area. Select ONLY ONE pathway. A pathway consists of 3 classes in the same area.  Identify the pathway you have completed or have taken the most classes.

Identify the block(s) you would like to enroll in WBL. You may REQUEST to enroll in more than one block. Please note:  this is only a REQUEST! Several factors must be checked before you are officially enrolled: (1) Academic requirements must come first (2) Attendance and discipline records must be approved by Administration (3) Job Placements must be approved by the WBL Coordinator.

After you graduate from high school, what are your general plans? Select ONE of the following answers.

This is the name of the business, company, etc.  (NOT THE SUPERVISOR NAME) You must have a job to be enrolled in WBL. If you are in the process of obtaining a job or you need my assistance, please indicate "CURRENTLY SEEKING".  You will need to contact me ASAP to confirm your employment. (912) 293-0303

This is the name of the person you report to at work. You must have a job in order to enroll in WBL. If you are in the process of obtaining a job or you need my assistance, please indicate "CURRENTLY SEEKING".  You will need to contact me ASAP to confirm your employment. (912) 293-0303

Identify the workplace number. NO DASHES OR PARENTHESIS. ENTER ONLY NUMBERS!!! EXAMPLE:  9121234567  You must have a job in order to enroll in WBL. If you are in the process of obtaining a job or you need my assistance, please indicate "CURRENTLY SEEKING".  You will need to contact me ASAP to confirm your employment. (912) 293-0303

Read each statement below.  WBL students are expected to be strong representatives of  the WBL program as well as their school, parents/guardians, community, and most importantly-themselves! Please type your name on the line below if you can verify all statements.

First and Last name of your parent or guardian that you live with.

Provide the best contact for the person your listed above.  Enter number with no dashes (5555555555).

In order to enroll in Work-Based Learning, you MUST attend the MANDATORY Orientation.  Please look over the different meetings below and select (ONE) the best day/time for your schedule.  Mark your calendars!  Parents are invited to attend the orientation!  Orientations will last approximately one hour and will be held on the campus of SECCA (located behind Southeastern Technical College in Vidalia).  If you enroll in 1st Semester WBL and attend the mandatory orientation, you do not need to attend it again 2nd semester.