Tampa CCD Registration Form : Florida Construction Career Days

Name(Required)

First Last

Company/School Name(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Email Address(Required)

Phone Number(Required)

Please check the box for each area you intend to participate.

You may check multiple boxes.

Sponsor / Career Center

Yes

Equipment

Yes

Learning Lab

Yes

Volunteer

Yes

Attend

Yes

Equipment Operator

Yes

In-Kind Donation

Yes

(water, goody bags, shirts, lanyards, snacks, MOT devices, etc.)

I Do Not Wish To Participate In Any Activities

Yes

Please Check this box to submit form if you DO NOT wish to participate in any of the above volunteer opportunities.

Sponsor

Please fill out sponsor questions below

Please Note: Sponsors submitted after March 13th will not be recognized on print materials including T-shirts.

Please Note: If you intend to host a table in our career center, please also check the career center box and fill in the required information. Career Center Booths are available to Platinum and Gold Sponsors Only or to those making donations in excess of $1000.

Please check sponsor level

Platinum

Gold

Bronze

Donation

Platinum $1500

(Inclusion of company name on CCD T-shirts, sponsor board, website link and Career Center Booth)

Do you wish to host a Career Center Booth?(Required)

BOOTH INCLUDED WITH SPONSOR

Yes

Gold $1000

(Inclusion of company name on sponsor board, website link and Career Center Booth)

Do you wish to host a Career Center Booth?(Required)

BOOTH INCLUDED WITH SPONSOR

Yes

Bronze $500

(Inclusion of company name on sponsor board, website link)

Donation

Donation Amount(Required)

Please fill in donation amount below

Do you wish to host a Career Center Booth?

(only applicable if your donation is in excess of $1000)

Yes

Pay By PayPal or Check

PayPal and check payment information will be available after submitting this form

Paying by PayPal or Check?

PayPal

Check

Volunteer

Please fill out volunteer questions below

Equipment Operators-Go back and check the equipment operator box and fill in your information there.

Please Note: This section is for general volunteers that can be utilized by our committee to run the event. Uncheck the volunteer box at the top and do not fill in this section if your volunteers are being assigned to your company’s learning lab, career center, etc. Their information should be entered in the appropriate section for their participation.

Setup Dates(Required)

Set Up Day – March 20, 2024 (Wednesday)

Event Day – March 21, 2024 (Thursday)

Equipment

Please fill out equipment questions below

Please Note: You are providing equipment for student use.

Students are supervised by active equipment operators from FDOT while performing specific tasks as instructed by the operator.

I am providing equipment for STUDENT USE(Required)

Yes

How many pieces of equipment will you provide for student use(Required)

Are you providing your own operator(s)(Required)

Yes

Operator(s) Names(Required)

Learning Lab

Please fill out learning lab questions below

Learning Lab Details

Lab size: 20’ x 20’ Space
Includes 20 Chairs for students and 2 chairs for lab hosts
Lab Duration: 20 minutes with each group of students
Total # of students expected to register: 1000
Approximate # of students that will visit your learning lab: 500

Number of Participants in Your Learning Lab(Required)

Names of all participants(Required)

Please add participant NAMES to below fields. Click plus symbol to add multiple names

Please Describe Your Lab in Detail

Will you require a table(Required)

Yes

How many chairs would you like for students(Required)

Do you need electricity for your lab(Required)

Yes

What is the electricity for

Do you need an exterior space(Required)

Yes

Please any additional information/requests

Career Center

Please fill out career center questions below

Number of Participants in Your Career Center(Required)

Names of all participants(Required)

Industry Represented(Required)

Is your company interested in providing student internships?(Required)

Yes

Is your company interested in employing students after high school graduation?(Required)

Yes

Do you require electricity?(Required)

Yes

In Kind Donation

Please fill out in kind donation questions below

Please Note: If the value of your donation corresponds to one of our sponsor levels, you will receive the same benefits as that sponsor level. If your donation equals or exceeds the Gold or Platinum levels, you are also eligible for a career center booth.

Sponsor Levels

Platinum $1500
Gold $1000
Bronze $500

Describe Your Donation(Required)

Approximate Value of Donation(Required)

Attend

Please fill out attend questions below

Please Note: This section is for those that are attending as a school to participate in the event or as an individual that wants to visit the event. If you are attending as an individual, you will be guided through the event on a 15-20 minute tour. Snacks, breakfast, and lunch are not provided for individuals touring the event.

If you intend to volunteer or participate in some other way, please uncheck the attend box and check the correct box that corresponds to your level of participation.

Please select the type of entity that will be attending(Required)

Special Guest

Business

Government

School (A member of the school committee will contact you)

Other

All Attendee Names from your company (n/a for schools)(Required)

Please check each piece of equipment that you are experienced in operating and can operate on event day without supervision or instructions. Do not check the box for any equipment you are unwilling to operate at the event.

Please select the type of equipment you will operate(Required)

Skidsteer

Roller

Excavator

Loaders

Man Lift