WISCONSIN YOUTH APPRENTICESHIP Interest Survey
Please complete the application electronically using Microsoft Word. Date: Click here to enter a date.
Put an “X” next to the Youth Apprenticeship you are considering:
☐ Arts/AV Com. Graphic Tech. ☐ Architecture/Construction ☐ Financial Services
☐ Hospitality/Tourism ☐ Information Technology ☐ Manufacturing
Health Science Pathway:☐ Dietary Aide ☐ Level 1 Nursing Assistant ☐ Pharmacy Technician
☐ STEM: Drafting, Design, Engineering ☐ Transportation
BACKGROUND INFORMATION
Student Name: Click here to enter text.
Address: Click here to enter text. City: Click here to enter text. Zip: Click here to enter text.
Home Phone: Click here to enter text. Date of Birth: Click here to enter a date.
School Name: Click here to enter text. Student ID: Click here to enter text.
Grade Level in School: Click here to enter text. Current Grade Point Average: Click here to enter text.
Email Address: Click here to enter text. Cell Phone Number: Click here to enter text.
Transportation/Availability:Do you hold a valid driver’s license? Choose an item.
If yes, do you have access to and use of a car? Choose an item.
If no, describe how you will get to and from work. Click here to enter text.
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Please email interest survey to Terri Salzer: [email protected]
OR turn in to your school’s Career Champion.
