MBSK Lansing Opportunity Hub Student Registration 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 Question Title * 1. First and Last Name Question Title * 2. Age Question Title * 3. Grade Question Title * 4. School You Attend Question Title * 5. Do you live in the Lansing area? Yes No Not sure Question Title * 6. What is your email address? Question Title * 7. What is your phone number? Question Title * 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 Question Title * 9. What is your gender? Female Male Non-binary Prefer not to say Other 🔹 Trusted Adult Contact Question Title * 10. Please provide the name and contact info for a parent, guardian, or trusted adult we can reach out to if needed. Question Title * 11. Phone and/or Email: 🔹 Your Interests Question Title * 12. Which of the following opportunities might be of interest to you? Entrepreneurship Program Job/Employment Career Readiness Internship Job Shadowing Having a Mentor Other (please specify) 🔹 Getting Connected Question Title * 13. How do you prefer to receive updates? Text Email Phone Call Other (please specify) Question Title * 14. Do you need help with transportation to get to programs or events? Yes No Maybe – depends where it is Question Title * 15. 15. Do you currently have a job or any work experience? Yes No Not yet, but I want to Question Title * 16. Anything else you'd like us to know? Done