3/10 YA Interview Registration
Student Full Name
*
First Name
Last Name
Student Email Address
*
example@example.com
Parent 1 Email Address
example@example.com
Parent 2 Email Address
example@example.com
Transportation
*
Self - Student provides their own transportation to the interview
Ride Provided - Lincoln provides transportation. The interview shuttle leaves from the circle drive at:
Time that Interview Shuttle Leaves (picks up in circle drive)
Please Select
8:30 AM
9:00 AM
9:30 AM
10:00 AM
10:30AM
11:00 AM
11:30AM
12:00 PM
12:30 PM
1:00 PM
1:30 PM
2:00 PM
2:30 PM
3:00 PM
Excused/Pass (autofilled):
Time Excused (self ride)
*
Time Excused (interview shuttle only)
*
Interview Time Text Only
YA Career Area
Please Select
Animal Care
Bioscience Lab
CNA (Hospital & Clinic)
IT
Medical Office
Pharmacy Technician
Physical Therapy Assistant
Interview Date #1
Interview Day of Week (hidden)
Interview Month (hidden)
Interview Time
Hour Minutes
AM
PM
AM/PM Option
Select Interview Time
*
YA Career Area #2
Please Select
Animal Care
Bioscience Lab
CNA (Hospital & Clinic)
IT
Medical Office
Pharmacy Technician
Physical Therapy Assistant
Interview Date #2
Interview Time #2
Hour Minutes
AM
PM
AM/PM Option
Select Interview Time #2
YA Career Area #3
Please Select
Animal Care
Bioscience Lab
CNA (Hospital & Clinic)
IT
Medical Office
Pharmacy Technician
Physical Therapy Assistant
Interview Date #3
Interview Time #3
Hour Minutes
AM
PM
AM/PM Option
Select Interview Time #3
YA Career Area #4
Please Select
Animal Care
Bioscience Lab
CNA (Hospital & Clinic)
IT
Medical Office
Pharmacy Technician
Physical Therapy Assistant
Interview Date #4
Interview Time #4
Hour Minutes
AM
PM
AM/PM Option
Select Interview Time #4
Register
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