MCC Career Connection

Student Information Form

1.) Personal Information


I am interested in participating in:
First name
Last name
Student M#
Email Address
Address 1
Address 2
City
State
Zip
Home phone
Cell phone
Preferred method of Contact
Number of Credits Complete
Current Major

2.) Career Interest

Career field in your area of interest:

  • Business
  • Communications
  • Computer
  • Criminal Justice
  • Education
  • Engineering
  • Government
  • Health
  • Helping Professions
  • Skilled Trades
  • Visual Arts
  • Hospitality

Company(ies) of interest, if applicable (ex: Wegmans, Paychex, Strong Hospital, etc.):


3.) Agreement

I realize that I am representing Monroe Community College and agree to honor the following:

  • I understand that this experience is about career development, not job hunting.
  • I will complete and return the contact evaluation form.
  • I understand that I am solely responsible for my actions/inactions during the experience. I will adhere to the Policy Statement on Sexual Harassment found on page 263 of the online catalog.
  • I understand and agree that Monroe Community College, its Board of Trustees, faculty, staff, agents and/or employees are not responsible for any injury, damage or loss incurred by me during the informational interviewing or job shadowing visit.
  • I hereby agree to and shall save and hold harmless Monroe Community College, its Board of Trustees, faculty, staff, agents and employees, from any claims, actions, of judgments arising from my actions or inactions during the information interviewing/job shadowing experience.

I do hereby affirm that I have read this Agreement and the Policy Statement on Sexual Harassment and I accept all responsibilities contained herein.

We are continuously adding contact names to our employer database and we make every attempt to provide you with a name in your area of interest. However, there may be instances where we are unable accommodate your request.
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