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School-to-Career Application
Youth Apprenticeship & CO-OP Programs
Student Information:
Students Name
*
First Name
Last Name
Student's Email:
*
example@example.com
Student's Birthdate:
*
-
Month
-
Day
Year
Date
Student Phone Number (Parent if student's not available)
*
Please enter a valid phone number.
Format: (000) 000-0000.
Student Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student's current grade
*
10
11
12
Which school year are you interested in Youth Apprenticeship?
*
2025-2026
2026-2027
What is your unisex t-shirt size? (May be used for program apparel)
*
XS
S
M
L
XL
XXL
XXXL
Student's Current School:
*
Central
Coulee Region Virtual Academy
Logan
Polytechnic
Who is your School Counselor? (Central)
*
Jandrin
Tomesh
Welter
Jaksic
Who is your School Counselor? (Logan)
*
Knoble
Adams
Eichenberg
Who is your School Counselor? (Poly)
*
Villa
Who is your School Counselor? (CRVA)
*
Villa
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Student Involvement:
Which areas have you volunteered in, if any?
School
Community
Church
Non-Profit
Other
Please do your best to list any Career & Technical Education Courses that you have taken. These are courses in Agriculture, Family & Consumer Sciences, Business, Marketing, Technology/Engineering, Health, Health Occupations, Graphic Arts, etc. This information is important in determining if you are a strong candidate for the School-to-Career Program. Please be as complete, as possible.
*
Which career pathway(s) are you most interested in?
*
Agriculture, Food & Natural Resources
Architecture & Construction
Arts, A/V, Technology & Communication
Business, Management & Administration
Education & Training
Finance
Government and Public Administration
Health Science
Hospitality & Tourism
Human Services
Information Technology
Law, Public Safety, Corrections & Security
Manufacturing
Marketing, Sales & Services
STEM (Science, Technology, Engineering and Mathematics)
Transportation, Distribution & Logistics
Please list any responsibilities or obligations that you have after normal school hours. Check all that apply and explain in "other" which parts of the year these may occur. Example: Sports- Track & Field only
*
Sports
Current employment
Childcare responsibilities
Community/Family activies
Are you currently employed anywhere?
*
Yes
No
Where are you currently employed?
*
Since you are currently employed, is this a position that are you hoping would turn into a youth apprenticeship position?
*
Yes
No
Maybe
Please use this space to briefly explain why you are applying to the Youth Apprenticeship program.
*
Parent/Guardian Approval- It is required for your parent/guardian to approve your participation in the program. If you are approved, the Youth Apprenticeship coordinator will meet with your parent/guardian to ensure that they approve your participation. Please list the best person to contact regarding your involvement. Below list their relationship to you, their phone number or email. Thanks!
*
Lastly, it is important that you have a strong adult recommendation. Please list a name and contact information for a person would has agreed to serve as a reference to you. Suggestions include employers, CTE Educators, Mentors, Advisers, etc. NOT peers
*
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Terms and Conditions
I understand that by completing this application, I am not guaranteed a Youth Apprenticeship position.
*
Agree
Disagree
I understand that a Youth Apprenticeship placement may take time to secure, and information regarding opportunities may not be immediately available.
*
Agree
Disagree
I understand that I will potentially go through a shadow experience, an interview process with potential employers, and may or may not be offered a job. This will be decided by the employer.
*
Agree
Disagree
I understand that I may pursue a Youth Apprenticeship placement for myself as well.
*
Agree
Disagree
Signature
*
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