WORKPLACE EXPERIENCE APPLICATION
2024-2025 SCHOOL YEAR
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First Name *
Last Name *
Student ID *
Cell Phone Number *
E-Mail Address *
Please elaborate on your career ambitions in 35 words or less. *
(Ex. I plan on enrolling at Waubonsee Community College in the Summer. After two years, I would like to seek a position as an administrative assistant . . . . )
Work & Career
For candidates seeking to be a Teacher's aide ONLY: Please check the classes you have taken.
Starting with your current employment (if any), please list the last two part-time jobs you have held.  For each, please include the following:  Company Name, Dates of Employment. *
Example:  McDonald's (March 2023 to October 2023) & JCPenney's (November 2023 to Present)
Do you intend to stay at your current job (if applicable) or do you plan on obtaining another part-time job for your senior year in high school? Please Explain. *
High School Records
Have you been absent more than three school days since the beginning of your Sophomore year in high school (ignoring approved field trips)? *
Required
If yes, please explain the circumstances and comment on your ability to have better attendance going forward. *
Have you received any referral or disciplinary action while in high school? *
Required
If you answered yes, please explain.
List one of your high school teachers who can attest to your character and serve as a reference. *
( Ex. Mrs. Sajder-Adams, BusinessTeacher)
What is your cumulative GPA? *
(Must be accurate as of last full semester)
Do you have any responsibilities or obligations which would interfere with your ability to complete the necessary 12-15 hours per week? (Examples: sports after school, community activities, etc.) *
If yes, please explain.
VERIFICATION AND UNDERSTANDING
I understand that, if accepted into the program, Workplace Experience students will meet in the classroom for one period the entire year. The Workplace Experience class will be taught the first semester and Consumer Education (a graduation requirement) will take place the second semester. *
Required
I have a driver's license and ready access to a vehicle (or other means) for commuting to and from work. *
Required
I understand it is the student's responsibility to find and retain suitable employment. *
Required
I understand it is my obligation to let my counselor know I have applied for Workplace Experience (I.C.E. Class/Work) during registration. *
Required
I have fully informed my parents and they are aware of my obligations under the program.   *
All statements and information provided within this application are true and correct.  I understand and agree to follow the above policies and procedures.  I understand that failure to comply with the standards of the Workplace Experience (I.C.E.) program may result in dismissal from the program and loss of credit. *
Required
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