CAP Application

CAP APPLICATION FORM

* denotes a required field

First Name*:


Last Name*:


Email*:


Phone number*:

Mailing Address

Street*:


City*:


State*:


School*:


Grade*:

Referral from a teacher or school administrator is required to participate in this program. Please indicate the name and contact information of the person who referred you.

Teacher/Adminstrator Full Name*:


Teacher/Administrator Email*:


How did you hear about this program?
TeacherSchool Career ResourcesS2S StaffS2S CommunicationsSocial MediaOther

Have you previously participated in an S2S program?
YesNo

If yes, please indicate which program:


Which CAP offerings are you most interested in? * (Select all that apply)
Career FairsCertification ProgramsEmployment OpportunitiesInternshipsJob ShadowingMentoringPost-secondary EducationSkill-based Employment TrainingWorkplace Tours
Which of the following STEM industries are you currently most interested in?* (Select all that apply)


Briefly explain why you are interested in an S2S internship*:


Briefly explain why you are interested in participating in the CAP:

Parent/Guardian Contact 1

First Name*:


Last Name*:


Email*:


Phone number*:


Relationship*:

Parent/Guardian Contact 2

First Name*:


Last Name*:


Email*:


Phone number*:


Relationship*:

Emergency Contact

First Name*:


Last Name*:


Email*:


Phone number*:


Relationship*:

Email Opt-In:

*I confirm that by submitting this application, I approve of my email being added to any communications about S2S program notifications, updates, and future opportunities.

Questions? Email us at [email protected]