Student 5.0 Interest Form
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Student 5.0 at ReadyCT
—
A free career launch program for Class of
'27
high school graduates.
Thank you for your interest in Student 5.0! A member of the team will be in touch shortly after you submit this form.
Participant Information
First Name
Last Name
Cell Phone Number
Personal Email Address
Date of Birth
What is the best way to reach you?
Please select...
Email
Phone Call
Text Message
What is the best time to reach you?
Please select...
Afternoon
Evening
Weekend
What is your goal?
Please select...
Certificate/Training Program (short-term training that leads to a career such as Culinary, Cosmetology, Manufacturing, C.N.A., etc.)
College Enrollment (2 years/community college)
Employment (Full or part-time)
Trades (construction, plumbing, welding, electrician, etc.)
Unsure
Other
Provide more details about your goal
School Information
Name of High School
Please select...
Bulkeley High School
Bristol Central High School
Bristol Eastern High School
Bristol Preparatory Academy
CREC Academy of Aerospace and Engineering
CREC Academy of Computer Science and Engineering
CREC Academy of International Studies
CREC Academy of Science and Innovation
CREC Greater Hartford Academy of the Arts
CREC Impact Academy
East Hartford High School
Flight School, MHS
Hartford Magnet Trinity College Academy
Hartford Public High School
Kinsella Magnet School
Manchester High School
Middletown High School
New Britain High School
Pathways Academy of Technology and Design
Satellite Careers Academy (NBHS)
Synergy Alternative High School
Weaver High School
Other
High School Name
Grade
Please select...
9
10
11
12
Recent high school graduate
Parent/Guardian Contact Information
Student 5.0 staff will reach out to your parent/guardian if you are under 18 years old to share information about the program. Please fill out the information below so that we can contact them:
Parent/Guardian First Name
Parent/Guardian Last Name
Relationship
Please select...
Mother
Father
Stepmother
Stepfather
Grandmother
Grandfather
Aunt
Uncle
Sister
Brother
Legal Guardian
Foster Parent
Other
This helps us understand who we’re reaching out to.
Parent/Guardian Phone Number
Parent/Guardian Email Address
ReadyCT
| 350 Church Street, 10th Floor, Hartford, CT 06103 |
(860) 244-1109
