WBL Application
Applicant Information
Please enter your full school email address and select an option from the search results. If your email is not displayed, or you see an incorrect email address (if any), click the checkbox below to manually enter in your contact details.
School Email Address
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First Name
Middle Name
Last Name
School Email Address
Personal Email
Preferred Email
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Personal
School
What name would you like to be called?
Additional Details
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Gender
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Woman
Man
Non-Binary
I decline to state
I prefer to self-identify
Pronouns
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She/Her/Hers
He/Him/His
They/Them/Theirs
Other
Prefer Not To Answer
Pronouns (other)
Race
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American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latinx
Native Hawaiian or Other Pacific Islander
White
Multi-Racial
Other
Do not know
Prefer not to answer
Ethnicity
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Hispanic or Latinx
Non-Hispanic or Latinx
Arab
Do not know
None of the Above
Prefer not to answer
Date of Birth
Applicant Email Validation Message
Applicant Phone Number
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Applicant Alternate Phone Number
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Address
Street Address
Address Line 2
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
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Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Montana
Nebraska
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New Hampshire
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New Mexico
New York
North Carolina
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Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Zip Code
Additional Information
What options do you have for transportation to work (check all that apply)?
Walk
Bus
Drive Myself
I have a reliable ride
Who do you live with? (check all that apply)
Mom
Dad
Grandparent(s)
Aunt(s)
Uncle(s)
Other
If you selected other, please add more details.
Parent/Guardian Information
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Phone Number
Please enter without any spaces, dashes or symbols.
Parent/Guardian Email Address
Relation to Applicant
Email Validation Message
The parent/guardian email and the applicant email cannot be the same email address. Please input a unique email for the applicant and the parent/guardian.
School and Interest Information
I am applying for:
CTE Work Based Learning Internship
What CTE classes have you taken or are taking?
When do you plan on participating in WBL? (select all that apply)
All year
1st semester
2nd semester
1st trimester
2nd trimester
3rd trimester
What school are you currently attending?
Please select...
Climax-Scotts
Comstock
Comstock Compass
Comstock Virtual
Galesburg-Augusta
Gull Lake
Gull Lake Gateway
Gull Lake Virtual
Hackett Catholic Prep
Heritage Christian Academy
Homeschool
Kalamazoo Central
Kalamazoo Christian
Kalamazoo Covenant
Kalamazoo Innovative Learning Program
Loy Norrix
Parchment
Parchment Innovation Center
Phoenix
Portage Central
Portage Community
Portage Northern
Schoolcraft
Vicksburg
Vicksburg Pathways
What grade are you in?
Please select...
10th
11th
12th
I am MOST passionate about a career in the following industry
Please select...
AV Technology
Agriculture
Architecture
Arts
Aviation
Automotive and Transportation
Business, Management, and Administration
Communications Media
Construction
Culinary
Design
Distribution and Logistics
Education and Training
Energy
Engineering
Finance
Government & Public Administration
Grocery Store
Healthcare and Health Science
Hospitality and Tourism
Human Services
Information Technology
Insurance
Law
Manufacturing
Marketing
Natural Resources and Conservation
Public Safety
Retail
Security
Veterinary Science
Other
What other industry are you most passionate about?
Counselor Information
Name
My counselor is not on this list
First Name
Last Name
Email
Employment Information
Have you ever had a job before?
Yes
No
Are you currently working?
Yes
No
Previous Employer
Place of employment
Job Title
You can optionally add information for a second previous employer below.
Place of employment
Job Title
Current Employer
Place of employment
Job Title
Hours Per Week
Supervisor Name
Supervisor Phone Number
Please enter without any spaces, dashes or symbols.
Supervisor Email (If Known)
Job Tasks
Do you plan to continue to work for your current employer while enrolled in WBL internship?
Yes
No
Have you discussed this with your employer?
Yes
No
What type of position are you looking for?
At this time, do you have a potential job opportunity?
Yes
No
Business Name
Contact Name
Phone Number
Please enter without any spaces, dashes or symbols.
I understand that I will NOT be officially enrolled in the WBL program until:
* my WBL coordinator has approved my placement AND
* I have met with my WBL coordinator to sign all required paperwork.
NOTICE OF NONDISCRIMINATION: It is the policy of the KRESA school district not to discriminate on the basis of race, color, national origin, gender, age, disability, height, weight or marital status in its programs, services or activities. The following person has been designated to handle inquiries regarding the nondiscrimination policies: KRESA Human Resources Department, 1819 E. Milham Ave, Portage MI 269-250-9200
Hidden Fields
Lead ID
Contact ID
WBL RT ID
CTE RT ID
Student RT ID
Guardian RT ID
Application Owner ID
Counselor ID
Contact Information