IBEW Local 163 Field Trip

Electrical Union IBEW Local 163 Field Trip

Saturday, April 15, 2023
Bus pick ups at Hazleton Area High School at 9:15 am.

Trip Itinerary:

Morning-IBEW Local 163 Training Facility in Nanticoke.

Lunch

drop off back at school

Wear comfortable clothing and walking shoes.

Questions? estephany@eocinc.org or 570-417-8414

Text: 570-417-8414

Open to Hazleton Area High School Students interested in learning more about apprenticeships
Name*

First NameLast Name
Email*
example@example.com- prefer not school email
Cell Phone*
Please enter a valid phone number- texting is needed.
School that you attend:*
Grade that you are currently in:*
Student's Date of Birth*
Student Citizenship Status*
I need most help with*
I want to go on this trip because:*

I'm interested in a career in a tradeI like the idea of learning more about Electrical professionsI have no idea what I want to be when I grow upI just like Field TripsOther
I am interested in this career:*
Please read the attached 'Informed Consent and Assumption of Risk' form
Student Signature: I have read, understand, and agree to the informed consent and assumption of risk form.*

Clear
Parent/Guardian Name*

First NameLast Name
Please list any allergies (food/bees,etc)
Parent or Guardian Phone number*
Please enter a valid phone number.
Parent Email Address*
example@example.com
Parent 1 Highest Education Completed*
Parent 2 Highest Education Completed*
Household taxable income*
Household income is: *
This in reference to the household taxable income in the question above.
Parent Permission and Signature: My signature indicates that I have read, understood and agree to the attached 'Informed Consent and Assumption of Risk' form.*

Clear
Should be Empty:

Electrical Union IBEW Local 163 Field Trip