Pre-Program Student Skill Assessment

Semester-Based Internship Program (90-Hour Work-Based Learning)

Purpose of This Form
This assessment is used to understand each student’s current skill level, interests, and readiness for participation in the Go Local FXBG Semester-Based Internship Program. Results are used to individualize support, place students in appropriate career pathway tracks, and establish a baseline for measuring skill growth throughout the semester.

This assessment is not a test and does not determine acceptance. It helps ensure a supportive, educational experience aligned with student needs.

Section 1: Student Information

First Name *

Last Name *

Phone *

Email *

School Division *

High School *

Current Grade *

Section 2: Career Interest & Track Preference

Please select up to TWO career pathway tracks you are most interested in from the dropdown:

Career Interest & Track Preference *

career-track

Briefly Explain Why You Choose These Tracks *

Section 3: Digital & Technology Readiness

(Self-Assessment — No prior experience required)

For each statement, pick the option that best describes your current comfort level.

Scale:
1 = No experience
2 = Beginner
3 = Some experience
4 = Comfortable
5 = Very confident

Skill Area

Section 4: Communication & Professional Skills

Section 5: Track-Specific Experience

Have you had any prior exposure (school, clubs, personal projects, or curiosity) in the areas below? Check all that apply.

Check What You Have Exp With *

Creating content (posts, videos, graphics)

Helping organize events or projects

Working with spreadsheets or data

Editing videos or media

Building or updating a website

Using AI tools (ChatGPT, image tools, etc.)

Community service or outreach

None — I’m here to learn

If yes, briefly describe: *

Section 6: Learning Style & Support Needs

Is there anything you would like us to know to better support your learning?(Examples: scheduling needs, learning preferences, accommodations, etc.) *

Section 7: Availability & Commitment

Are you able to commit to approximately 5–10 hours per week from February through May? *

Yes

Unsure

Section 8: Student Statement

In 3–5 sentences, tell us: What do you hope to learn or gain from this internship experience? *

Section 9: Acknowledgment

I understand that this program is a structured, educational Work-Based Learning experience focused on learning, skill development, and professional growth.

Student Signature: *

Clear

Date: