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Outreach for K-12

Electrical Technology Center, Rm. 136 · (570) 320-8003

Career Day Session Commitment Form

Please complete this form
 if you want to conduct a session on Career Day.

Career Day activities take place from 9 a.m. to 2 p.m.

Spring Career Day is for students in grades 7 - 9 ONLY.
Fall Career Day is for students in grades 9 - 12 ONLY.

Completing this form indicates your commitment that you will deliver the activities as specified.

Registration Information

( * = required fields )
 
* Legal first name:
* Legal last name:
* E-mail address:
DIF number:
College extension:
Select your school:
Other
* Title of activity:
* Detailed description (Sell your activity! Attract students! This will be listed in the flyer!)
Length of sessions: minutes
After you complete this form, you will be given an opportunity to select time slots for sessions of this activity. The time slots available will be based on the "length of sessions" you selected.
Room # and Bldg. where activity will be held:  Room # accepts text
Is the room a computer lab? Yes
No
* Maximum number of participants that each session can accommodate:
Give specific number of 6 foot tables and chairs you need (Outreach for K-12 will do work order).  Tables
 Chairs
If you need any laptops, you need to complete a form at least a week in advance through Information Technology Services web page:
http://www.pct.edu/its/Laptop/Guidelines.htm

 Will you use any instructional or projection equipment?
Check all that apply: Networked computer and data projector
TV/VCR
Overhead projector
Projection screen
Other [Please specify]
Other Equipment:
Will you be bringing any instructional or projection equipment with you to use?
Check all that apply: Networked computer and data projector
TV/VCR
Overhead projector
Projection screen
Other [Please specify]
Other Equipment:
Do you intend to use student workers as part of your session? Yes
No
Each student worker is provided with a $30 gift certificate at the College Store. They are expected to be available for 5.5 hours.
If yes, how many do you plan on using?
There are some funds available for curricular supplies. Please call Outreach for K-12 at (570) 320-8003 or e-mail CareerEd@pct.edu to discuss and to coordinate the ordering of supplies.
Are you regularly scheduled to work at Penn College on Career Day? Yes
No		 You must select a value
here to reveal the submit button.