2025-2026 CO-OP Application

Before you begin this application you will need the following information and/or documents:

Your employer's phone number and email address

An electronic copy of your Resume
2025-2026 Cooperative Education Application

Complete each section. Incomplete applications will not be considered for enrollment. Signatures for each section will be collected at the end of the application.
Application Date

MonthDayYear
Date
Application Term*

2025-2026 School Year2025-2026 S2 ONLY
Graduation Year*

Class of 2026Class of 2027
Base Campus*

ECHSHHSSEHSWHSEDGE
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student's PERSONAL Email Address*
example@example.com
Parent's First & Last Name*
Parent's Primary Contact Number*
Please enter a valid phone number.
Parent's Secondary Contact Number*
Please enter a valid phone number.
Parent's PERSONAL email address:*
Provide an email address that is checked regularly.
Do you have a driver's license?*

YesNo
What is your driver's license number?
Do you have daily access to a vehicle to get to and from work?*

YesNo
Will you have a DL AND daily access to a vehicle before school starts?

YesNo
If you answered no to either of the last two questions, please explain how you plan to get to and from work daily?
Are you under a doctor's care for any health problems that would interfere with your regular attendance at a job?

YesNo
If you answered "yes" to the above question, please explain
List any extra curricular activities you are involved in:*
Are you currently employed?

YesNo
Who is your employer? This is a company or business name NOT an individual's name.*
When did you start working at your current job?*

MonthDayYear
Approximate date is fine.
Employer's Email Address*
example@example.com
Employer's Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How many class periods/credits of CO-OP do you want on your schedule?

S1 ONLY - 1 Credit - 140 hours Aug - DecS2 ONLY - 1 Credit - 140 hours Jan - MayS1 ONLY - 2 Credits - 280 hours Aug - DecS2 ONLY - 2 Credits - 280 hours Jan - MayALL YEAR - 1 Credit - 140 hours Aug - Dec + 140 hours Jan - MayALL YEAR - 2 Credits - 280 hours Aug - Dec + 280 hours Jan - May
Employer's Phone Number*
example@example.com

Previous Work Experience (List most recent first)

	Employer	Type of Work	Employment Dates
Past Job
Past Job

How many class periods/credits of CO-OP do you want on your schedule?

1 Credit - 140 hours2 Credits - 280 hours
The number of classes/credits requested is NOT guaranteed. CO-OP periods will depend on the rest of your schedule. One class (credit) of CO-OP requires 140 verifiable work hours. Two classes (credits) require 280 verifiable work hours.

If you are at a block schedule school and are accepted to CO-OP, talk to your counselor regarding which semester(s) you want to be scheduled for CO-OP.

ECTC Cooperative Education/WBL Regulations & Policies

Read Carefully! You are responsible for adhering to ALL ECTC and base campus policies related to CO-OP. Initial below after reading each one. Signatures will be collected at the end of the application.
1. Student acknowledges that the primary purpose of Cooperative Education is educational and, therefore, agrees to abide by the Cooperative Education (CO-OP) program policies and decisions of the CO-OP Teacher-Coordinator.
2. Student acknowledges that the school, through the CO-OP Teacher-Coordinator, is acting as an intermediary between the training mentor and student and that the CO-OP Teacher-Coordinator has a legitimate right to know and a significant role in determining the outcome of any workplace issues including, termination, scheduling, assignments, and all other aspects of student workplace. CO-OP students are under the supervision of the CO-OP Teacher-Coordinator and training mentor at their CO-OP workplace.
3. Cooperative Education is a year-long commitment. Mid-year requests for schedule changes WILL NOT be considered.
4. Once CO-OP is added to a student’s schedule, it cannot be dropped and the schedule cannot be changed.
5. CO-OP students who fail to perform satisfactorily in all subject areas during any grading period and who fail to improve during the next grading period may be asked to resign from his/her workplace and placed in additional courses at the base school.
6. CO-OP students must comply with the Elmore County Public Schools attendance policy to participate in the program earn CO-OP credit.
7. A student not attending regular school classes cannot work at the CO-OP workplace on the day(s) he/she is absent from school.
8. In case of unplanned absence from school or work, the student is required to notify the CO-OP Teacher-Coordinator and his/her training mentor before class or working period.
9. A student suspended from school may not be allowed to attend their CO-OP workplace during the suspension. On the second offense he/she may be dropped from the CO-OP program with a failing grade and loss of all credit.
10. A student is to be on time at school as well as the CO-OP workplace.
11. A student losing his/her CO-OP workplace due to any action deemed unacceptable by the school and CO-OP Teacher-Coordinator will lose all CO-OP credit and may not reapply any subsequent year or term.
12. A student whose CO-OP workplace is terminated for any reason is to notify the CO-OP Teacher/Coordinator by emailing tara.baker@elmoreco.com from your elmoreco student email. Failure to do so may result in a failing grade and loss of all credit.
13. Personal business handled at the CO-OP workplace is prohibited.
14. Friends or family are not to visit the student at the CO-OP workplace.
15. Parents should understand the student’s responsibility to the training CO-OP workplace and not interfere with the performance of his/her duties.
16. Industry rules for dress and personal hygiene will be observed.
17. Since training is the primary objective, a student is expected to remain with the CO-OP workplace in which he/she is working when accepted to the program. Students may resign or change workplaces only with the express written permission of the CO-OP Teacher-Coordinator and following business practices for resignation. Students who fail to follow these procedures may fail to earn credit in Cooperative Education.
18. The career tech student organization (CTSO) is an integral part of a student’s Career and Technical Education program. Therefore, all students are expected to participate in and actively support the Career and Technical Education student organization that relates to their career objective. (Ex. DECA, FBLA, FCCLA, FFA, HOSA, SkillsUSA)
19. CO-OP is an extension of your school enrollment. Students must abide by all school rules and regulations for other students and consider themselves under the jurisdiction of the school while at the CO-OP workplace. Activities prohibited on school campus and/or at school events are also prohibited in the CO-OP workplace.
20. Transportation to and from the CO-OP workplace is to be arranged by the student/parent/guardian. Transportation problems do not justify absence from the CO-OP workplace.
21. Students will leave the campus immediately following the last scheduled class. If for any reason a student needs to remain on campus, permission must be obtained in writing from the CO-OP Teacher-Coordinator, School Administrator, or CTE Instructor.
22. Other base campus policies: Your base campus may have policies and procedures in place in addition to those listed here. It is your responsibility to make yourself aware of those policies and remain in compliance.
I have read the rules and procedures for Work-Based Learning students and agree to follow them.

Yes
I have read the rules and procedures for Work-Based Learning students and agree to follow them.

Yes
Student Initials*
Parent Initials*

ECTC Cooperative Education/WBL Emergency Contacts

Please provide the name, address, and telephone number of at least one person who may be contacted in the event of an emergency.
Contact 1*
Relationship*
Phone Number*
Please enter a valid daytime phone number.
Contact 2
Relationship
Phone Number
Please enter a valid daytime phone number.
ECTC Cooperative Education/WBL Student Release

Initial below after completing. Signatures will be collected at the end of the application.
ECTC CO-OP/WBL STUDENT RELEASE & Insurance Documentation

I, Student Name* and Parent Name* have received a copy of the Cooperative Education/Work-Based Learning Policies and Procedures for the Elmore County Board of Education Program. I understand that if enrolled my child will participate in the CO-OP program. I will support my child by ensuring his/her attendance at school and work in order for him/her to be successful in completing the graduation requirements for the Elmore County Board of Education. I understand that confidential information related to job performance may be released to individuals and agencies concerned with the employment of this student.
Parent Initials*
Student Initials*
Student Name*
Please indicate which type of insurance:*

PrivateSchoolOther
Name of Insurance Company*
It is required that students who are enrolled in Cooperative Education must be covered by accident and/or hospitalization insurance before they will be allowed to participate in the work of the course.
Parent Initials*
To my knowledge, the information above is an accurate and true statement concerning the status of my child’s insurance.

ECTC Cooperative Education/WBL Teacher Recommendations

Provide the names of three teachers that would be willing to complete a recommendation form for you. Three teacher recommendations are required. One must be a Career Tech teacher. Career Tech does not mean ONLY a class taken at ECTC. Career Tech classes are offered on all base campuses (FACS, AG, Business, Finance, JROTC, Culinary, Sports Medicine, etc.)
Career Tech Teacher - First and Last Name*
Program*
Teacher #2 - First and Last Name*
Subject*
Teacher #3 - First and Last Name*
Subject*

ECTC Cooperative Education/WBL Application Signatures & Submission
To the Student:
Elmore County Cooperative Education provides an opportunity to be considered for employment in business and industries in our area. You further understand that NO employment is guaranteed. You must apply, interview, and compete for the
placement based on your skill, your abilities, and your aptitude. When you enroll in Cooperative Education, you indicate that you are sincerely interested in putting forth your best efforts to receive work-based experience. By submitting this
application to participate in Cooperative Education/WBL you are agreeing that you understand that you must maintain employment for the entire term of enrollment in CO-OP/WBL.

If you accept this responsibility, please initial below.
Student Initials
To the Parent/Guardian:
Do you consent to your child entering Cooperative Education/Work-Based Learning, arranging transportation, and agree to cooperate with the school and the training agency in making the training and education of the greatest possible benefit to
your child? If so, please indicate your support and approval with your initial below.

By signing this application to participate in Cooperative Education/WBL you are agreeing that you understand that
- My child must maintain employment for the entire term of enrollment in CO-OP/WBL
- I have read the rules and procedures for CO-OP/Work-Based Learning students and agree to follow them
- I verify that I understandthat, if accepted and enrolled, my child will participate in the co-op program for the 2025 - 2026 school year.
- I will support my child by ensuring his/her attendance at school and work in order for him/her to be successful in completing the graduation requirements for the Elmore County Board of Education.
- I understand that confidential information related to job performance may be released to individuals and agencies concerned with the employment of this student.
Parent Initials
I have read this application in its entirety and agree to all policies & procedures set forth. I further acknowledge that all information I have provided is accurate. This signature will appear in all sections of this application where an acknowledgement by initials is required.
Student Signature*

Powered by Jotform SignClear
I have read this application in its entirety and agree to all policies & procedures set forth. I further acknowledge that all information I have provided is accurate.
Parent Signature*

Powered by Jotform SignClear
I have read this application in its entirety and agree to all policies & procedures set forth. I further acknowledge that all information I have provided is accurate.
Parent Phone*
Best daytime phone number
Parent E-mail*
Important information will be sent to this email address. Be sure this email is accurate.
Elmore County Public Schools does not discriminate on the basis of race, color,national origin, sex, disability, or age in its programs and activities and provides equalaccess to the Boy Scouts and other designated youth groups. The following personhas been designated to handle inquiries regarding the non-discrimination policies: Steve McKenzie (504 Coordinator/Title IX Coordinator) 100 HH Robinson Dr. Wetumpka, Al 36092 334-567-1200
Resume & Addition Required Items
In order to complete the applicaiton process, students are required to complete the following IN ADDITION to this application:
- Resume
- Interest Inventory
- Student Interview
- Attend Orientation
Check your email for instructions on completing the Interest Inventory, Student Interview, and Orientation. Upload your Resume below. Applications will not be accepted without a Resume. The following file types are accepted:
- PDF
- DOC
- DOCX
Don't already have a resume? Here are some good resume builder resources:

Alabama Community College System Career Coach - https://accs.lightcastcc.com/?radius=®ion=Alabama (Resume Builder is an option in the top menu)

Jobscan - https://www.jobscan.co/blog/how-to-write-a-resume/

Get Schooled - https://getschooled.com/resume-help/
Resume Upload*

Accepted file types are PDF, DOC, DOCX
Cancelof
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Your Employer/Supervisor will be responsible (along with you, the CO-OP student) for completing the following documents which will be sent to them separately:
- Training Agreement
- Training Plan
- Safety Documentation
- Paystub Agreement
If you were unable to provide a good email address for them, you will need to provide that ASAP. Students will not be eligible to be scheduled for CO-OP until ALL documents are received from your employer.
Should be Empty:

2025-2026 Cooperative Education Application

ECTC Cooperative Education/WBL Regulations & Policies

ECTC Cooperative Education/WBL Emergency Contacts

ECTC Cooperative Education/WBL Student Release

ECTC Cooperative Education/WBL Teacher Recommendations

ECTC Cooperative Education/WBL Application Signatures & Submission

Resume & Addition Required Items