Career Connections Registration

*First Name:

*Last Name:

*School:

*Date of Birth (YYYY-MM-DD):

*Home Address:

*City:

*State:

*Zip Code:

*Emergency Contact Name:

*Emergency Contact Relationship:

*Emergency Contact Phone Number:

*Career Cluster Choice 1:Select Career Cluster from listAgriculture, Food and Natural ResourcesArchitecture and ConstructionArts, A/V Technology, and CommunicationBusiness Management and AdministrationEducation and TrainingFinanceGovernment and Public AdministrationHealth ScienceHospitality and TourismHuman ServicesInformation TechnologyLaw, Public Safety, Corrections and SecurityManufacturingMarketing, Sales, and PromotionScience, Technology, and EngineeringTransportation, Distribution, and Logistics

*Career Cluster Choice 2:Select Career Cluster from listAgriculture, Food and Natural ResourcesArchitecture and ConstructionArts, A/V Technology, and CommunicationBusiness Management and AdministrationEducation and TrainingFinanceGovernment and Public AdministrationHealth ScienceHospitality and TourismHuman ServicesInformation TechnologyLaw, Public Safety, Corrections and SecurityManufacturingMarketing, Sales, and PromotionScience, Technology, and EngineeringTransportation, Distribution, and Logistics

*Alternate Career Cluster Choice:Select Career Cluster from listAgriculture, Food and Natural ResourcesArchitecture and ConstructionArts, A/V Technology, and CommunicationBusiness Management and AdministrationEducation and TrainingFinanceGovernment and Public AdministrationHealth ScienceHospitality and TourismHuman ServicesInformation TechnologyLaw, Public Safety, Corrections and SecurityManufacturingMarketing, Sales, and PromotionScience, Technology, and EngineeringTransportation, Distribution, and Logistics