Student Sign-Up

Student Registration

Students wanting to register for LHRMA’s 1st Job-Lincoln program must submit this completed form by Feb. 12th, 2021.

Student's Name*
First Last
Have you participated in 1st Job-Lincoln before?*
If Yes, what year?
Current Age*
Date of Birth*
MM slash DD slash YYYY
Home Address*
Street Address Address Line 2 City State ZIP Code
Preferred Daytime Phone Number*
Preferred Evening Phone Number*
Can we text you? (Communication is usually by email, but we may text on occassion.)
Email Address*
High School*
Grade Level*
Parent's Names*
First Last
Parent Email*
Parent Phone Number
I am currently enrolled in The Career Academy in the following IT pathway class.*
I am not enrolled in The Career Academy but am taking the following IT class at my high school:*
Is your IT instructor aware that you are registering for 1st Job-Lincoln?
I agree to attend and participate in 1st Job-Lincoln activities as follows:  Feb. 25 “ACE IT” session (Accountability, Customer Service, and Enthusiasm in the Workplace)  Mar. 4 “Mock Interviews” (bring resume, dress appropriately)  Mar. 25 Job Fair (meet the Champion Employers)  July 15 “Celebration Event”*
I agree to participate in follow-up surveys for project evaluation purposes.*
I give permission to have my picture taken and used for promotional purposes on 1st Job-Lincoln's website, Facebook, etc.*
By submitting this form, I am confirming that the information provided is true and correct to the best of my knowledge.
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.

By submitting this form, I am confirming that the information provided is true and correct to the best of my knowledge.