Academy Application

Program Information:

The Academy is an afterschool program that pairs Ottawa Area high school students (9th-12th) with local businesses to provide innovative solutions to challenges businesses are facing. Students have the opportunity to explore career areas they are excited about, get to know businesses in our community and start to develop a career plan. Students completing the 8 week program will earn three (3) college credits to help build their portfolio. In addition, college scholarships will be awarded to top performing students at the end of the program. Space is limited, so apply quickly to ensure you get a spot!

There is a $25 course fee to participate. Financial assistance is available for qualifying families. To inquire contact ngitler@oaisd.org before starting the application.

* First Name

Middle Name

* Last Name

* Date of Birth

* Address

* City

* State

* Zip Code

* Phone Number

The best number to reach you

* School

* Current Grade Level

* Student's School Email

* Parent/Guardian First Name

* Parent/Guardian Last Name

* Parent/Guardian Relationship

* Parent/Guardian's Email

* Parent/Guardian's Phone

* Emergency Contact Name

* Emergency Contact Phone

* Emergency Contact Relationship

* Primary Language Spoken at Home

* T-Shirt Size

* Of the six career pathways listed, rank your top four (4) areas of interest

Industry	If You Like	Potential Careers
Agriculture	Being outside, science, problem solving, working with others, animals and/or plants	Veterinarian, Food Safety Technician, Environmental Engineer, Forester, Veterinary Technician
Arts and Communication	Using your imagination, details, organization, designing, creating, working with others, working on a computer	Graphic Designer, Public Relations, Event Planner, Media Communications, Web Designer, Editor
Business, Management, Marketing & Technology	Details, people, multitasking, being creative, computers	Finance Manager, Public Relations, Network Administrator, Software Developer, Sales Director, Accountant, Human Resources Officer
Engineering/Manufacturing	Creativity, problem solving, details, math, technology, working with your hands	Engineer (Manufacturing, Industrial, Electrical), Robotics Programmer, CNC Programmer, Welder
Health Sciences	Details, people, organization, numbers, science, working under pressure	Physician, Dentist, Firefighter, Athletic Trainer, Rehab Therapist, Nurse, EMT
Human Services	Multitasking, creativity, people, serving others, problem solving	Teacher, Police Officer, Counselor, Social Worker, Public Servant, Community Advocate, Principal

* Explain why you would like to be considered for the futurePREP’d Academy program

* How could this program help you achieve your educational and career goals?

* Are there any special circumstances we should be made aware of?

Release of Photograph and/or Name: If selected to participate in the futurePREP’d program, I give permission for Ottawa Area Intermediate School District (OAISD) and it’s futurePREP’d partner organizations to use photographs or digital images/ recordings for display and/or promotional purposes as and when required, including in print, video or any other format or publication determined by OAISD. I also give OAISD permission to publish my name in conjunction with the use of these photographs or images, and to quote or record statements from me for promotions, advertisements, publicity, and other purposes. I understand and agree that the OAISD may use these images on the Internet, and may copyright or otherwise protect its use of these images.

* Student/Parent agrees to the photograph/name release:

Student/Parent Statement of Commitment: Acceptance into a futurePREP’d program brings with it certain responsibilities for the student, parent/guardian, and the partnering companies/organizations. The futurePREP’d program will offer a variety of opportunities for academic and personal development. Meeting these requirements listed below is essential to success in the program. Responsibilities for the student will include, but are not limited to:

Adhere to proper dress code
Attendance & participation
Professional behavior
All regular school work Is maintained
Positive behavior

***If these responsibilities are not met, program membership may be terminated***

* Student/Parent agrees to the futurePREP'd commitment:

Student/Parent Academic Transcripts Permissions: I give my permission for the futurePREP’d program staff to obtain any of my/my students' academic or personal records which are deemed necessary to assist me/my child before, during or after participation in the program.

* Student/Parent agrees to the Academic transcript release:

Transportation Permission: I give my permission for my child to ride in OAISD provided/approved transportation.

* Parent agrees to transportation permission:

Please either enter your Scholarship Code or enter your credit card information to pay the $ charge.

Scholarship Code

Credit Card Number

Credit Card Security Code

Expiration

First Name on Card

Last Name on Card

Billing Address

City

State

Zip Code

Withdrawal/Cancellation Policy:

If for any reason you must withdraw your application, please notify us as soon as possible by emailing futureprepd@oaisd.org or call (616) 738-8950 x4034.

* - Required Value

The OAISD does not discriminate on the basis of race, color, religion, sex, national origin, age, height, weight, marital status, handicap, disability, or limited English proficiency in any of its programs or activities. The following office has been designated to handle inquiries regarding nondiscrimination policies: Human Rights Officer, Human Resources Department – Ottawa Area Intermediate School District – 13565 Port Sheldon Street Holland, MI 49424 – 1-877-702-8600 (toll free)