Work-Based Learning Experience Request Form
Submit separate form for each course and section
Days and Times of Class
Age range or grade of students participating
Estimated Number of Students Participating
What virtual work based learning experience would you like?
1 career guest speaker
Career guest speaker series
Career panel (3 or more speakers)
Career expo (4 or more speakers)
What to Be Episode
If other, please explain what you are looking for
Please list 3-4 referred dates or times you would like the activity to be held (please list dates that are at least 5 weeks out).
Please describe the careers, career sectors, or companies that you would like to have involved in this activity (i.e. Panel with 3 different careers from tech, agriculture career speaker, virtual tour of manufacturing facility)