Job Opportunities/ Work-Based Learning Interest Form

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Please complete the fields below if you are interested in being considered for job opportunities with business partners of the Perry Career Academy or would like to earn elective credit for your current job.

Email *

First Name *

Last Name *

Date of birth *

YYYY

Email address *

Cell Phone Number *

Availability *

Do you have reliable transportation? *

Yes

Please check opportunities that interest you: *

Forklift Certification

Warehousing & Distribution

CNA Training

Customer Service Representative

Construction careers/training

Food Service - restaurant greeter, cook or server

Other:

Required

Are you currently working? *

Yes

Are you interested in earning elective credit for working by enrolling in Work-Based Learning? *

Yes

Maybe

What is your career objective? *

What courses have you taken related to your career objective?

A copy of your responses will be emailed to the address you provided.

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