2023-2024 WBL Application-Vidalia
Please complete the form below PRIOR to the mandatory orientation (orientation dates are listed at the bottom of this form).  
Deadlines for WBL enrollment:
1st Semester:  Friday, August 4, 2023 @ 3:00 pm
2nd Semester:  Friday, January 5, 2024 @ 3:00 pm
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Email *
First Name *
Enter YOUR First name
Last Name *
Enter YOUR last name.
Student Cell # *
Identify YOUR best contact number. Enter number with no dashes (5555555555).
Student Grade *
I will be in the ??? grade for the 2023-2024 school year. 
Pathway *
Pathways must be in a CTAE area. A pathway consists of 3 classes in the same area.  Identify the pathway you have completed or have taken the most classes.
Pathway Completion  *
If you have completed all three (3) classes in your selected pathway, check the first option - Pathway Completer.  If you have not completed all three (3) classes in your selected pathway, check the year/semester you plan to complete the three (3) classes in your selected pathway.
WBL Years *
Is this your 1st or 2nd year enrolled in WBL?
Requested WBL Blocks *
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-students must be on track for graduation
(2) Attendance and discipline records must be approved by Administration 
(3) Job Placements must be approved by the WBL Coordinator
(4) Pathway Completers are eligible for 2 blocks
Required
Plans After Graduation *
After you graduate from high school, what are your general plans? Select ONE of the following answers.
Required
DE Student? *
Have you completed a Dual Enrollment class or are you currently enrolled in a Dual Enrollment Class? If so, identify the type of classes you have taken.  For example, if you have taken English, Math, Psychology, etc., then you select Yes, Core Classes Only.  If you have taken Welding, Health Science, etc. then you select Yes, Classes in my Career Pathway.  If you have not taken any classes for DE credit, you select No.
Employer Name *
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. 
Supervisor Name *
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.
Work Phone Number *
Identify the workplace number. NO DASHES OR PARENTHESIS. ENTER ONLY NUMBERS!!! EXAMPLE:  5555555555  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. 
Verification Statements *
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 FIRST AND LAST NAME on the line below if you can verify all statements.
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Parent / Guardian Name *
First and Last name of your parent or guardian that you live with.
Parent / Guardian Contact Number *
Provide the best contact for the person your listed above.  Enter number with no dashes (5555555555).
ORIENTATION *
-In order to complete the WBL enrollment process, all students MUST attend a MANDATORY Orientation. 
-Look over the different meetings below and select the best day/time for you.  Mark your calendars! 
-Parents are invited to attend the orientation, however, please do not bring friends with you to the orientation .
-Orientations are one hour-plan to arrive early!!! No one will be allowed to enter after the orientation begins. 
-All orientations will be held on the SECCA campus (located behind Southeastern Technical College, Vidalia).
-If you enroll in WBL 1st Semester and attend orientation, you do not need to attend it again 2nd semester. 
-Orientation for 2nd Semester is for new students enrolling in WBL for the first time.
A copy of your responses will be emailed to the address you provided.
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