Student Sign-Up

Students wanting to register for LHRMA’s 1st Job-Lincoln program must submit this completed form by Feb. 1st, 2019.

Student's Name*
First Last
Have you participated in 1st Job-Lincoln before?*
If Yes, what year?
Current Age*
Date of Birth*
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. 22 “ACE IT” session (Accountability, Customer Service, and Enthusiasm in the Workplace)  Mar. 7 “Mock Interviews” (bring resume, dress appropriately)  Mar. 28 Job Fair (meet the Champion Employers)  July 18 “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.
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Name
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.