Industry Employer/Professional Interest Form
Thank you for you interest in engaging with our School District as an Employer Partner offering WBL experiences for our students. Please complete this form to share more about your organization and availability.
What is your name? *
What is your business/organization name?
What is your job title?
Email address *
Preferred phone number *
Where is your organization located? Street Address, City, State, Zip
Company website
What is your gender? (optional - this information can be used to help match students)
Male
Female
Non-binary
Racial/Ethnic Identity? (optional - this information can be used to help match students)
American Indian / Native American
Asian
Black / African American
Latino / Hispanic
Native Hawaiian / Pacific Islander
White
What languages do you speak? (optional - please select all that apply as this information can be used to help match students based on any potential language needs) *
English
Somali
Arabic
Spanish
French
Portuguese
Kirundi
Vietnamese
Khmer
Kinyarwanda
Chinese
Dari
Sign Languages
Maay-Maay
Bengali; ben
Chuukese
Russian
Japanese
Tagalog
Nepali
Hmong
Thai
Swahili
Q'anjob'al
Filipino
Turkish
Romanian
Kurdish
Korean
Other languages
Pilipino
Hindi
Sinhala
Persian
Navajo
Telugu
Ladino
Lao
Faroese
Tamil
Kannada
Dinka
Mayan Languages
Hebrew
Bulgarian
Ukrainian
Madurese
Triqui
Farsi
Mam
Pashto
Which Career Cluster best describes your organization? (please select all that apply) *
Agriculture, Food & Natural Resources
Architecture & Construction
Arts, A/V Technology & Communications
Business Management & Administration
Education & Training
Finance
Government & Public Administration
Health Science
Hospitality & Tourism
Human Services
Information Technology
Law, Public Safety, Corrections & Security
Manufacturing
Marketing
Science, Technology, Engineering & Mathematics
Transportation, Distribution & Logistics
What are the types of experiences you're interested in participating in or offering? (please select all that apply) *
Clinical/Practicum/Internship
Service Learning
School-Based Enterprise Experience
Workplace Simulation/Technology-Based Learning
Cooperative Work Experience
Pre-Apprenticeship
Registered Youth Apprenticeship
Fieldtrips
Job Shadow
Mentoring
Mock Interview
Advisory Board Participation
Career Presentation (Virtual)
Career Presentation (In Person)
Participate in Career Highlight Videos
Which grade levels are you able to serve? (please select all that apply)
12
11
10
9
09
Middle School
Elementary/K-6
What is the best time of year for you to engage with this program?
Jan-March
April-June
July-Sept
Oct-Nov
Can you provide additional information about what kind of WBL opportunities you can offer or anything else that you'd like to share at this time?
Submit
