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FieldTrip Application
Plant City Career Academy
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FieldTrip Application
Name
*
First
Middle Initial
Last
Date of Birth
*
Street Address
*
City
*
State
Zip
What School Do You Currently Attend?
*
Please select
Plant City High School
Simmons Career Center
Durant High School
Strawberry Crest High School
Email
*
Work Experience
Employer
Supervisor
Start Date
End Date
Rate of Pay
Skills –rate yourself on a scale of 1-5, 1 being not proficient at all, 5 being extremely proficient
Verbal/Telephone Communication
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1
2
3
4
5
Computer/Typing
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1
2
3
4
5
Writing
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1
2
3
4
5
Attention to detail
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1
2
3
4
5
Reading
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1
2
3
4
5
Basic math (algebra, geometry)
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1
2
3
4
5
Advanced Math (trigonometry, calculus)
Please select
1
2
3
4
5
Customer Service
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1
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4
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Education
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?
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