Corporate & Community Partnerships  
09/26/2016

 
CONTACT INFORMATION
First Name:
Last Name:
Street Address
Apt/Room No.:
CIty:
State:
Zip:
Cell Phone Number:( ) - -
Additional Phone Number:( ) - -
Email Address:
Retype to Verify Email Address:
 
PROGRAM INFORMATION
I am requesting job search assistance.
Adult or High School program?
Which Program did you complete?
Your Instructor's Name:
Graduation Year/Month:Month: Year:
 
ADDITIONAL EDUCATION PLANS AFTER GRADUATION:
College/Technical School/Military
What will you study? Which School? Military Branch?
Have you applied?
Have you been accepted?
EMPLOYMENT INFORMATION:
Current Employer:
Job Title:
Job Duties:
Hourly Pay:
JOB SEARCH ASSISTANCE:
If we are unable to reach you about a job opportunity, is there someone else we could call or email?
Name
Relationship:
Phone Number:( ) - -
Contact Email:
COMMENTS:
 
 
I would like to receive Polaris electronic newsletters:
 
 
 
For more information contact: 
Pam Vizer, Coordinator of Corporate Partnerships
pvizer@polaris.edu
440.891.7622
Chris Anderson, Secretary
canderso@polaris.edu
440.891.7607