SDSU Extension Workforce Education Course Access Request Form

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
School Name* This field is required.
4
Role* This field is required.(Teachers please review the follow-up email for additional information on how to add your class.)
Student
Teacher
Parent
Other
5
Would you like to provide your students direct access to the career content? (this allows the teacher to assign to your students as well as view their progress within the course)
Yes (student will need their own email address)
No
6
GradePlease add the grade you are in or teach, for students and teachers.
NA
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
Post-Highschool Education
School Support Staff
7
Course Registration* This field is required.
Career Conversations: Exploring My Future in the 605
Operation Occupation: Unlock Your Potential
8
Expected number of youth reached
9
GenderNon-discrimination Data Collection.SDSU Extension is an equal opportunity provider and employer in accordance with the nondiscrimination policies of South Dakota State University, the South Dakota Board of Regents and the United States Department of Agriculture. Learn more at extension.sdstate.edu/equity. Applicants who prefer to not provide the following identity information will not have their eligibility to participate in the program impacted.
Female
Male
Prefer not to respond
10
EthnicityNon-discrimination Data Collection.SDSU Extension is an equal opportunity provider and employer in accordance with the nondiscrimination policies of South Dakota State University, the South Dakota Board of Regents and the United States Department of Agriculture. Learn more at extension.sdstate.edu/equity. Applicants who prefer to not provide the following identity information will not have their eligibility to participate in the program impacted.
Hispanic/Latino
Non-Hispanic/Latino
Prefer not to respond
11
RaceNon-discrimination Data Collection.SDSU Extension is an equal opportunity provider and employer in accordance with the nondiscrimination policies of South Dakota State University, the South Dakota Board of Regents and the United States Department of Agriculture. Learn more at extension.sdstate.edu/equity. Applicants who prefer to not provide the following identity information will not have their eligibility to participate in the program impacted.
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian/Other Pacific Islander
White
Prefer not to respond
Should be Empty: