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RockATOP Manufacturing Apprenticeship Application

The student application is open to current juniors and seniors who attend a public school, private school, NC registered home school, or charter school in Rockingham County, NC.

Please note: Applicants must attend at least one open house at a RockATOP sponsor company WITH a parent/guardian in November/December to be eligible to have their application considered.

AFTER completing the below application, applicants must print and obtain signatures on the Signature Page prior to the Dec. 19 deadline. Signatures include applicant, parent/guardian, and school representative.

Deadline: December 19, 2023

Step 1 of 5

20%

STEP 1: Personal Info
Student Information
Name*
First Last
Email*
Use your official school email address if available.
Cell Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Date of Birth*
MM slash DD slash YYYY
Parent / Guardian Information
Name*
First Last
Relationship to Student*
Email*
Cell Phone*
Home Phone

STEP 2: Educational Background
High School Type*
If other, please specify:*
High School Name*
If Home School or Other, please list name here:
School Counselor/ CDC/ Home School Administrator Email*

The email address is required to request a transcript and attendance record with a signature on the completed application.
Grade Level*
- 11 (Junior)
- 12 (Senior)
List any Career and Technical Education (CTE) course you are taking/have taken at your current high school:
Please list the name and the year of the course [e.g., Robotics (Fall 2018), 3D Modeling & Animation (Spring 2019), etc.]

STEP 3: Interests & Career Information
Education plans after high school?*
(Check all that apply)
- Apprenticeship
- 2-Year Degree
- 4-Year Degree
Are you available for a Pre-Apprenticeship assignment from June to August?*
- Yes
- No
Which apprenticeship pathway(s) are you interested in?*
- Advanced Manufacturing
- Undecided
This application is for RockATOP Manufacturing Apprenticeships (including IT, BUS, Welding, Machining, Fabrication, Maintenance, Electronics, Electrical, Lean Manufacturing, etc.) This is NOT the application for the Teacher Assistant Apprenticeship. Please visit the RockATOP Teach section of the rockatop.org website for more information on applying to RockATOP Teach.
Why are you interested in this opportunity?*
List any school, athletic, volunteer, or community activities.

STEP 4: Employment History (if applicable)
Job #1
Place of Employment
Employment Address
Street Address Address Line 2 City State ZIP Code
Employment Start Date
MM slash DD slash YYYY
Employment End Date
MM slash DD slash YYYY
Supervisor Name
First Last
Supervisor Phone
Description of Job Duties
Job #2
Place of Employment
Employment Address
Street Address Address Line 2 City State ZIP Code
Employment Start Date
MM slash DD slash YYYY
Employment End Date
MM slash DD slash YYYY
Supervisor Name
First Last
Supervisor Phone
Description of Job Duties

STEP 5: Program Requirements & Submission
Apprenticeship Program Information
How did you hear about RockATOP (Apprenticeship Program)?*
(Check all that apply)
- Career Development Coordinator
- School Counselor
- Career Coaches
- School Assembly Presentations
- Classroom Presentations
- Teacher
- Parent
- Friend
- Television
- Social Media (Facebook, YouTube, etc.)
- School Phone Message
- Other
If Other, please list here:
Is there any additional information you would like us to know when considering your application?
(If you would like to explain any issues or absences, or provide additional detail about anything listed above, please do so here.)
Have you submitted a RockATOP application before?*
- Yes
- No
Disclaimer
My signature below verifies that the above information is correct. I understand if I am selected for the program, I am responsible for abiding by the policies and procedures of my employer as well as the guidelines for the RockATOP program. I understand that I will be responsible for transportation to and from my work assignment. I understand that I must be eligible for work in the United States. I give permission for the RockATOP program and my employer to review my grades to verify that I am maintaining the standards set by this program.
Consent*
I agree to this policy.
Student Signature*
First Last
Date*
MM slash DD slash YYYY
Hidden
Parent / Guardian Signature
Hidden
Counselor Signature

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