First Name

Last Name

Phone Number

Email

City

State

Zip Code (5-Digit)

County

Language(s) (Do you speak English and/or Spanish fluently, and/or do you speak any other languages Fluently? Mark All that Apply)

EnglishSpanishOther

What Grade are you in?

9th Grade	10th Grade
11th Grade	12th Grade

Please enter your ACADEMY PATHWAY. This information will help our team connect you to the right Career Advisor!

"Academy Pathway" may be called something different at your school. It could be your "Academy," "Pathway," "Track," etc. If you're not sure, enter what you think it may be, or ask a trusted adult for help.

Male	Female
Non-binary	Transgender
Gender Nonconforming	Prefer not to say

He/Him	She/Her
They/Them	Ze-Hir
No Pronoun Identified

American Indian or Alaskan Native	Asian
Black or African American	Native Hawaiian or Other Pacific Islander
White	Hispanic or Latino
Middle Eastern or North African	Other
Prefer Not to Say

Self	Mother	Parent	Father
Son	Daughter	Dependent Child	Grandparent
Guardian	Spouse	Other Family Member	Other Non-Family
Ex Spouse	Other Caretaker	Aunt	Uncle
Brother	Sister	Cousin	Nephew
Niece	Grandchild	Unmarried Partner

INTEREST FORM

Thank you for your Interest in After the Tassel!

Our goal is to connect young adults with good jobs!

Please complete the form below, and a member of our team will reach out to get started!