1. Have you previously participated in one of our Career Camps?
Yes
No
2.A - Hillsborough County Sessions - 12335 University Mall, FL 33612 (You can select multiple sessions)
June 3 to June 14
June 17 to June 28
July 1 to July 12
July 15 to July 26
July 29 to August 9
2.B - Pasco County Sessions - B&B Theaters 6333 Wesley Gove Blvd. Wesley Chapel FL 33544 (You can select multiple sessions)
June 3 to June 14
June 17 to June 28
July 1 to July 12
July 15 to July 26
July 29 to August 9
2.C - Virtual Sessions - Microsoft Teams (9:00AM - 12:00 PM)
June 3 to June 14
June 1 to July 12
July 15 to July 26
July 29 to August 9
3. Are you the parent or legal guardian?
*
Yes
No
4. What is your First and Last Name?
*
First Name
Last Name
7. What is your email address?
*
example@example.com
5. What is your child's first and last name?
*
First Name
Last Name
6. What is the age of your child?
7. What is your child's email address
*
example@example.com
8. What is your phone number?
*
-
Area Code
Phone Number
9. Home Address
*
10. Zip Code
*
Stret Address
Street Address Line 2
City
State / Province
Postal / Zip Code
11. How old is your child?
*
12. What school does your child attend?
*
13. Please select the option that best applies to your child.
*
My child has a 504 plan
My child has an IEP
My child has another document which verifies that they have a disability
14. The student must complete the entire program for our organization to remain in compliance with State requirements.
*
My child will be able to complete the entire program
My child will not be able to complete the entire program
15. Does your child have any allergies? If so please indicate below
*
16. What industry is your child interested in?
*
Arts and Recreation
Educational Services
Financial Services
Healthcare/Medical
Hospitality/Tourism
Information Technology
Manufacturing
Marketing/Public Relations
Media/Entertainment
Real Estate/Property
Retail
Construction
Agriculture
17. Does your child have any medical conditions that staff should be aware of? Such as a seizure disorder or asthma? If so, please describe below:
*
18. Does your child have any allergies?
*
19.Does your child have any dietary restrictions?
*
20. How did you hear about our program?
*
21. Please list any accommodations needed if any:
Please write down anything that you'd like us to know to best assist your child during the program.
Submit
Should be Empty: