* 1. What is your name?

* 2. What is your phone number and email?

* 3. What would be the best way to contact you?

* 4. Would you like to come for 10 weeks or 20 weeks?

* 5.  At Career Trek, we offer bus transportation to programming for Junior Staff Mentors with the Participants OR you are welcome to find your own method of transportation to programming. Check to see if there is a nearby school near you where we can pick up from.

What is your plan for transportation to programming?

* 6. If taking the Career Trek Bus, which school would you like to be picked up at?

* 7. Which 4 Departments interest you?

Education (University of Winnipeg)
Theatre and Film (University of Winnipeg)
Criminal Justice (University of Winnipeg)
Geography (University of Winnipeg) 

Carpentry (Red River College)

Electronics (Red River College)
Creative Communications (Red River College)
Business (Red River College)

Engineering (University of Manitoba I)

Agriculture (University of Manitoba I)
Biology (University of Manitoba I)
Kinesiology and Recreation Management (University of Manitoba I)

Chemistry (University of Manitoba II)

Native Studies (University of Manitoba II)
Peace and Conflict Studies (University of Manitoba II)
Geology (University of Manitoba II)