Program Application Pg

Greenville High School
Greenville, Michigan

Program Application Page

Completing this application page will help expedite the placement process and provide me with the information that need to see if you meet he qualifications for the program you are applying for. Please be as thorough as possible when completing the application. If you don't have answers to some of the questions, please don't let that stop you from applying. You may meet the qualifications!

After completing the application, you will be contacted by me within a few hours to a few days. If this doesn't happen, please stop in to see me or email me , my purpose is to help you meet your goals, so please don't let time pass.

Please be as thorough as possible when completing this application!

*Personal Information*
First Name*:
Last Name*:
Grade*:
School*:
Career Pathway:
Email Address*:
Cell Phone Number*:
*Employment / Placement Information*
*Program Type:**
Do you have a current job?
Employer:
City:
Supervisor:
Telephone Number:
*Placement Interests*
Would you like to be released from school for your placement?
Have you discussed this with your supervisor?
Would your employer be able to use you during these release hours?
What hours would you like to be released (max. 3 hrs.):

* Required information