Opportunity Programs Interest Form

Thank you for your interest in our Transitions Opportunity programs. Students and families, please fill out this interest form to be contacted by our team regarding the Opportunity Programs.

IMPORTANT INFORMATION:
This information will be used to collect preliminary information, prior to registration for the Opportunity Programs. Please complete all information and click 'Submit' only once. Our Transition Opportunity Program Coordinator will reach out once registration is open for the course you indicated. Families will be contacted after registration is available in the order in which they filled out the form.

An automated confirmation will be sent to the email address you provided. If you don't receive it, please check your Spam folder or email us at wfd@ccm.edu.

We are excited to meet you!

**Fields marked with a red asterisk (*) are required.**

Which Transition Opportunity Program are you interested in attending?*

CULINARY OPPORTUNITY PROGRAM (COP)CULINARY OPPORTUNITY PROGRAM II (COP2) Requires: COP 1 and Validated ServSafeHORTICULTURAL OPPORTUNITY PROGRAMOFFICE ASSISTANT OPPORTUNITY PROGRAMHOME IMPROVEMENT RETAIL ASSISTANT

What semester and year are interested in attending?*

Fall 2025 (Estimated months September to December)Spring 2026 (Estimated months January to April)Fall 2025 (Estimated months September to December)

Comments or questions:

Name of Parent / Guardian*

First NameLast Name

Name of Student*

First NameLast Name

Student date of birth? *

Student age? *

Primary Email*

Confirmation Email

Alternate Email

Confirmation Email

Mobile Phone Number*

Please enter a valid phone number.

Alternate Phone Number

Zip Code*

5-digit Zip Code

Name of Contact person of Agency / School District*

First NameLast Name

Primary Email

Confirmation Email

Phone Number

Student shirt size for all programs?

Student pants size only for the Culinary program?

Has the student previously completed any Opportunity Programs?*

YesNo

Transitions Opportunity Programs

Fields marked with a red asterisk (*) are required.

**Fields marked with a red asterisk (*) are required.**