MBSK Lansing Opportunity Hub Student Registration (Summer 2026)

This form helps us connect you with programs, events, jobs, or mentors that match your interests. Fill it out honestly, there are no wrong answers!

🔹 About You

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1. First and Last Name

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2. Age

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3. Grade

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4. School You Attend

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5. Do you live in the Lansing area?

Yes

Not sure

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6. What is your email address?

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7. What is your phone number?

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8. What is your race or ethnicity?

Black or African American

Hispanic or Latino/a

White

Asian

Middle Eastern or North African

Native American or Indigenous

Mixed or Multiracial

Prefer not to say

Other

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9. What is your gender?

Female

Male

Non-binary

Prefer not to say

Other

🔹 Trusted Adult Contact

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10. Please provide the name and contact info for a parent, guardian, or trusted adult we can reach out to if needed.

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11. Phone and/or Email:

🔹 Your Interests

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12. Which of the following opportunities might be of interest to you? (check all that apply)

Entrepreneurship Program

Job/Employment

Career Readiness

Internship

Job Shadowing

Having a Mentor

Other (please specify)

🔹 Getting Connected

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13. How do you prefer to receive updates? (check all that apply)

Text

Phone Call

Other (please specify)

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14. Do you need help with transportation to get to programs or events?

Yes

Maybe – depends where it is

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15. 15. Do you currently have a job or any work experience?

Yes

Not yet, but I want to

MBSK Lansing Opportunity Hub Student Registration (Summer 2026)

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* 1. First and Last Name

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* 2. Age

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* 3. Grade

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* 4. School You Attend

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* 5. Do you live in the Lansing area?

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* 6. What is your email address?

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* 7. What is your phone number?

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* 8. What is your race or ethnicity?

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* 9. What is your gender?

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* 10. Please provide the name and contact info for a parent, guardian, or trusted adult we can reach out to if needed.

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* 11. Phone and/or Email:

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* 12. Which of the following opportunities might be of interest to you? (check all that apply)

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* 13. How do you prefer to receive updates? (check all that apply)

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* 14. Do you need help with transportation to get to programs or events?

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* 15. 15. Do you currently have a job or any work experience?

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* 16. Anything else you'd like us to know?

1. First and Last Name

2. Age

3. Grade

4. School You Attend

5. Do you live in the Lansing area?

6. What is your email address?

7. What is your phone number?

8. What is your race or ethnicity?

9. What is your gender?

10. Please provide the name and contact info for a parent, guardian, or trusted adult we can reach out to if needed.

11. Phone and/or Email:

12. Which of the following opportunities might be of interest to you? (check all that apply)

13. How do you prefer to receive updates? (check all that apply)

14. Do you need help with transportation to get to programs or events?

15. 15. Do you currently have a job or any work experience?

16. Anything else you'd like us to know?