Wood County Student Experience Application

Please complete all fields listed below unless noted.

Student Information

First Name   Last Name  
City, State, Zip      

School Information

Academic Institution Attending  
Degree Working On/Program  
Current Program Level  

Other Program
Semesters Completed  
Instructor's Name  
Instructor's Phone  
Instructor's E-Mail  

Student Experience Information

Type of Learning Experience (please indicate top three choices):

Other Experience Choice
Total Number of Hours Required  
Anticipated Start Date  
Anticipated End Date  
I am interested in this opportunity because (i.e., what I hope to gain):
I am a great candidate for this opportunity because (i.e. knowledge, skills, experience):
Current Degrees/Licensures (mark "N/A" if none):  


Please attach the listed files by clicking "Browse".

Your Résumé  
Class Syllabus  
Department Menu