Middlebury-Summer Career Exploration Summer Career Exploration Program-Middlebury Please enter the following information for student applicant:Name:* First Last Chosen Name: Please Select Your Personal Pronouns:he/himshe/herthey/themotherSelect Preferred PronounsMailing Address (Where Student Receives Mail):* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell Phone:*Personal (Home) Email:* Enter Email Confirm Email School Email:* Enter Email Confirm Email Please tell us the best way to contact you:* Cell Phone Email (Home) Email (School) Please select the Transition Counselor you work with:*Ray MasonKris KouwenhovenotherSchool Name:* How many weeks are you looking to work?* 3 weeks 4 weeks 5 weeks Please select the accommodation(s) you may need.* Interpreter Closed Captioning Other None at this time. If you selected "other" for accommodations, please describe what accommodations you will need below. Please select three (3) areas of work interest:* Animal Care Assistant Customer Service Representative Research Assistant IT Assistant Camp Counselor Aid Custodial Data Entry Processor Landscaping Library Assistant Parks and Recreation Teacher Assistant Office Clerk – General Graphic Design Marketing Retail Sales Person Restaurant – Cashier Restaurant – Host/Hostess Restaurant – Food Prep Hospitality Office Clerical – Legal Office Clerical – Health Cashier HR Assistant What are your current transportation options/resources?*Please enter the following information for parent/guardian information:Name* First Last Phone*Email* Enter Email Confirm Email