FieldTrip Application

Name*

First

Middle Initial

Last

Date of Birth*

Street Address*

City*

State

Zip

What School Do You Currently Attend?*

Email*

Employer

Supervisor

Start Date

End Date

Rate of Pay

Verbal/Telephone Communication

Computer/Typing

Writing

Attention to detail

Reading

Basic math (algebra, geometry)

Advanced Math (trigonometry, calculus)

Customer Service

Current State high school GPA

Estimated high school graduation date

Certifications

What do you hope to gain from this field trip?

What sets you apart from your peers?

This field should be left blank