Need assistance with registering contact
registration-question@teensatwork.net
Please complete the registration form.  Please allow 3 business days for your application  to be processed.
Upon completion of your application you will receive notification of your orientation date.  All students must
complete orientation with a parent or legal guardian before becoming officially enrolled into the program.  
If you are mailing in the registration application form please have a parent or legal guardian sign the
application before mailing.
or
No
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Teens at Work
"Preparing teens for the work place and the future"
Registration Application
Student Information
Session Requesting
Orientation Date Requesting (please list a
1st & 2nd preference)
Today's Date
First Name
 Middle Initial
 Last Name
 Sir Name
Address
 Apt #
City
 State
 Zip Code
Home Phone
(xxx-xxx-xxxx)
 Other Phone
(xxx-xxx-xxxx)
 Email Address
Age
High School Graduate
 Yes
High School Name
City
 State
 Zip Code
Parent or Legal Guardian Information
First Name
 Middle
 Last Name
 Sir Name
Work Phone
(xxx-xxx-xxxx)
 Other Phone
(xxx-xxx-xxxx)
 Email Address
There is a one time registration fee of $50.00.  Please press the submit button
to complete the registration process and make payment for the courses.   
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