PCI & Education Professions Application

Name of Applicant:*
Grade (Must be 11 or 12):*
Student's cell phone number or best way to contact:*
Career choice(s) you are considering:*
For which program are you applying?
- Out-Of-School Internship (2 or 3 class periods per semester, grades 11-12 only, 6 credits max)
Top two choices for an internship location (name of business or type of occupation)
Top two choices for an internship location (name of business or type of occupation)
- Education Professions/Cadet Teacher (2 or 3 class periods per semester, grades 11-12 only, 6 credits max)
School/Grade Level/Teacher Choice(s):
School/Grade Level/Teacher Choice(s):
List three teachers under whom you have studied that may be contacted as a reference.
1. 2. 3.
List the sports and extra-curricular activities you plan to participate in during next school year.
1. 2. 3.
Briefly explain why you want to be in the internship program: