Interest Form
DE State Parks Work Based Learning Program
Name
First Name
Last Name
Email
This will be the main form of communication during the enrollment process so please list an email you check regularly
Phone Number
Please enter a valid phone number.
Date of Birth (age verification for parental consent)
School you attend
Grade you will be in while participating in WBL-TREC?
Career Pathway
Will you be receiving school credit for your WBL experience?
Yes
No
Unsure (Speak with school counselor or Career Tech Coordinator for more info)
Availability
Monday AM
Monday PM
Tuesday AM
Tuesday PM
Wednesday AM
Wednesday PM
Thursday AM
Thursday PM
Friday AM
Friday PM
Park(s) of Interest
Seashore Region - Cape Henlopen
Seashore Region - Delaware Seashore
Western Sussex - Trap Pond
Kent Region - Killens Pond
Kent Region - First State Heritage Park (Dover)
North - Lums Pond (Bear/Middletown)
North - Fort Delaware
North - White Clay Creek (Newark)
North - Bellevue
North - Brandywine Creek
North - Brandywine Zoo
Do you have (or are you able to secure) transportation to your WBL placement?
Yes
No
Unsure
How many total hours do you need to complete for your WBL experience?
WBL Term options (select all that interest you)
One time (just to try it out)
Once per week for full semester
Once per week for full school year
More than once per week for full semester
More than once per week for full school year
Why are you interested in DE State Parks for your WBL experience?
Are there any projects or experiences you're hoping for in your WBL experience?
Are you familiar with DE State Parks? (Ex: Do you visit any parks, what do you like to do when you visit, have you volunteered in parks, etc)
Submit
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