Workshop Registration Form

"*" indicates required fields

Registrant Information

Participant Name*

First Last

Participant Personal Email*

Participant Phone*

Participant Date of Birth*

Education Status*

Participant Location*

Organization Name

Organization Email

Areas of Interest

Primary*

Secondary

Registrant Information

If you are registering on behalf of another participant, please tell us:

Your Name

First Last

Your Email

Your Phone Number

Grade Level

Enter student grade level if applicable

Parent/Guardian Name

Please note: This field must be completed if the participant is under 18 years old.

First Last

Parent/Guardian Email

Please note: This field must be completed if the participant is under 18 years old.

Parent/Guardian Phone

Please note: This field must be completed if the participant is under 18 years old.

Payment

Workshop Type

Career Lab

Internship Experience

Available Internship Experience Sessions

February 2 - March 27, 2026 (160 hours / 8-weeks)

June 15 - August 7, 2026 (160 hours / 8-weeks)

September 14 - November 6, 2026 (160 hours / 8-weeks)

September 14 - November 6, 2026 February 1 - March 26, 2027 Internship Experience (160 hours / 16 weeks)

Number of Internship Experience Seats

Number of participants attending the Internship Experience.

Please enter a number greater than or equal to 1.

Available Career Lab Sessions

January 12 - 16, 2025 (15 hours / 1 week)

Number of Career Lab Seats

Number of participants attending the Career Lab.

Please enter a number greater than or equal to 1.

Total

Payment Options*

Payment Method

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Internship Experience

hidden field to allow multi select sessions

Career Lab

hidden field to allow multi select sessions