College and Career Ready Set Go Registration Page

College and Career.. Ready, Set, Go – Registration Page

Step 1 of 3

Dear Parents and Caregivers,

This school year, your middle school child or children are part of a career preparation program at their school. Most of the program takes place during regular school hours but through remote learning with career-focused hands-on activities, virtual visits from career mentors, along with virtual field trips to colleges and job sites. We also offer career-focused activities afterschool for the whole family.

Our goal is to get middle schoolers “high school ready” and to make sure high schoolers are ready for careers and post-secondary training, like college. You as parents and caregivers are part of our success model. We ask you to partner with us as career coaches and mentors for your children. What is a “career coach” or “mentor”? It is an adult who is willing to provide support, knowledge, and time to aid in their student’s development and future success. We will provide you with information, resources and activities to inspire your child. We also hope these experiences in our program will foster a dialogue between you and your child about their future hopes and dreams and how to reach them.

Please complete the form to grant us permission to work with your child’s teacher to deliver programming. All student and parent information is private. We will have graded assignments and take attendance to measure student progress.
STUDENT INFORMATION
Student Last Name:*
Student First Name:*
Gender:*
- Male
- Female
Student Date of Birth:*
Date Format: MM slash DD slash YYYY
School Attending:*
2020-2021 Grade (Choose one):*
- 5th
- 6th
- 7th
- 8th
- 9th
- 10th
Student 900 Number (EMIS Number):
Student's Address:*
Street Address Address Line 2 City State ZIP Code

PARENT/CAREGIVER INFORMATION
Parent/Guardian Name: (First Last)*
Relationship to student:*
Cell Phone:*
Work Phone:
Parent/Caregiver Email
Parent/Guardian Name: (First Last)
Relationship to student:
Cell Phone:
Work Phone:
Parent/Caregiver Email:

BY ELECTRONICALLY SIGNING MY NAME IN THE FORM BELOW, I AGREE:
• To allow my student to participate in the College & Career Ready…Set…Go! program.
• To be a “Career Coach” to my student. (“Career Coach” Definition – An adult or older sibling who is willing to provide support, knowledge, and time to aid in a student development and future success.)
• To allow my student to go on up to two field trips during the year with the College & Career Ready…Set...Go! and Partners in Education staff, teachers, and background checked volunteers.
• To allow Partners in Education to access your child’s school records to collect information on student’s progress to measure student achievement.
PARENT/CAREGIVER AGREEMENT
PLEASE TYPE YOUR NAME BELOW TO ELECTRONICALLY SIGN THIS AGREEMENT
First Last
Date:
Date Format: MM slash DD slash YYYY
ADDITIONAL STUDENT SUPPORT
Photo Release:
Please initial if your child can be photographed. Our program uses photos for marketing purposes. Photos will NOT be sold and students will NOT be identified in the photos.
Release, discharge and hold harmless
Please initial if you release, discharge and hold harmless the College and Career Ready, Set, Go Program, its officers, agents, and employees from any and all claims or liability for personal injury or property damage my student may suffer while participating in program activities.

College and Career Ready Set Go Registration Page

College and Career.. Ready, Set, Go – Registration Page

Step 1 of 3

STUDENT INFORMATION

PARENT/CAREGIVER INFORMATION

PARENT/CAREGIVER AGREEMENT

ADDITIONAL STUDENT SUPPORT