CWEE | Contact Form

Student Contact Form

In order to participate in the CWEE Program, you must complete this contact form. If you have not enrolled for CWEE, please do so before completing this contact form. If you have any questions, please contact us at 661-362-3309 or at cwee@canyons.edu.

Personal Information

First Name
Last Name
Student ID
Email Address
Re-Enter Email Address
Home Phone Number
Cell Phone Number
Home Address
City
Zip Code
Are you over the age of 18?
Are you a high school graduate?

Employment Information

Company Name
Type of Business
Company Address
City
Zip Code
Business Phone
Supervisor's Name
Supervisor's Email
Your Job Title
Is your position an internship?
Is your position paid or non-paid?
How did you find this position?
List your duties / responsibilities at this job
Average Weekly Hours

Educational Information

What is your major?
Is your job related to your major?
What is your educational or career goal?

Enrollment Information

This section assumes you have already enrolled in CWEE. If you have not enrolled in CWEE, please do so before completing this contact form. Learn how you can register for CWEE here.

Semester you will take CWEE
CWEE Section Title
CWEE Section Number	(View Fall 09 Section Numbers) ( View Winter 10 Section Numbers & Titles)
Number of CWEE Units
Are you a returning CWEE student?

Agreement

The above statements are true to the best of my knowledge. I have read the program requirements and I understand that 1) failure to complete all requirements, 2) late completion, or 3) unsatisfactory work will have a negative impact on my grade in the course. I have enrolled in the CWEE course before submitting this contact form.

I Agree to the Agreement

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