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Culinary Program Interest Form

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Prospective Student Name*
Support Person Name
If seeking this information on behalf of the student
I am:*

Preferred Contact Method
How did you hear about The Culinary Program?*

Contact & Demographic Information

MM slash DD slash YYYY
What county do you live in?*
Are you currently in school?*
Which timeframe best describes your general availability to attend classes?*
Do you have reliable transportation?*

Disability Information

Please list and describe your disabilities, beginning with your primary disability.

Potential Student Agreement

Student Attributes for Admission & Success*
Personal:
Self-care: Each student is responsible for their own self-care, including but not limited to personal hygiene and maintaining a clean uniform and professional appearance. (We will study this further in ServSafe Food Handling.); Self-control: The ability to self-monitor and self-regulate behavior, use appropriate language and actions as well as avoid inappropriate outbursts; Able to communicate with others and express needs; Able to handle changes in routine and can be flexible in fluctuating circumstances; Able to self-administer medications.

Social-Emotional:
Workplace appropriate behavior: Applicant must be able to appropriately self-regulate and be aware of his/her own actions in relation to those around them; Respect: Students must show respect for self and others; Able to work in a team as well as individually; Remain organized during tasks and classwork; Self-Management and motivation; Manage assigned tasks with limited reminders; Effectively manage mild stress. (e.g. time demands, constructive criticism and coaching)

Cognitive:
Cognitive skills sufficient to function in a kitchen and learning environment; Ability to understand basic instructions and carry out those instructions, consistently with low to moderate supervision; Comprehend written text at a 5th grade level; Read and follow basic recipes and directions, including the transfer to action; Ability to recognize a hazardous/unsafe situation/environment and act upon it appropriately; Reasoning sufficient to understand a critique and/or constructive criticism; Sustained attention to workload over time and goal achievement

Vocational:
The student has the desire and motivation to participate in a pre-vocational educational experience; Willing to learn about and use commercial kitchen equipment such as mixers, gas stoves, hoods, convection ovens, and dishwashers; Can use basic technology (cell phone, laptop, etc.)
This field is for validation purposes and should be left unchanged.

Contact Information

Mailing:
PO Box 758
Huntingtown MD 20639

Office:
6201 Solomons Island Road
Huntingtown MD 20639

Email:
info@endhungercalvert.org

Phone:
410-257-5672

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End Hunger In Calvert County is a registered 501 (c)(3). © Copyright 2021. Tax ID # 80-0456174.

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