Form

Field location*
Position Applied For
Date:
- Month - Day Year
at
/ Hour Minutes
Date you will be available for work:
- Month - Day Year
at
/ Hour Minutes
General Information
First Name*
Last Name*
Phone Number*
Alernate Phone Number
E-mail*
Address
City
State
Date of Birth*
- Month - Day Year
at
/ Hour Minutes
How did you hear about Mile High Youth Corps?
Have you ever worked here before?
If yes, when?
Have you ever applied here before?
If yes, when?
Immigration Statement: Federal law requires that employers hire only individuals who are authorized to be lawfully employed in the US. In compliance with such laws, MHYC will verify the status of every individual offered employment with the company. All offers of employment are subject to verification of the applicant's identity and employment authorization, and it will be necessary for you to submit such documents upon employment.
Can you submit proof of your work eligibility?*
Employment History
Please list your last two employers, full-time or part-time.
1. Company Name:
Phone Number:
Job Title/Position:
Wage/Salary:
Dates of employment:
Responsibilities/Duties:
Reason For leaving:
2. Company Name:
Phone Number:
Job Title/Position:
Wage/Salary:
Dates of Employment:
Responsibilities/Duties:
Reason for leaving:
References
1. Name:
Phone Number:
Occupation:
Relationship to applicant:
2. Name:
Phone Number:
Occupation:
Relationship to applicant:
3. Name:
Phone Number:
Occupation:
Relationship to applicant:
General
Have you, in the last 7 years been convicted of a crime?*
Is there anything that would prevent you from performing the essential job functions in a reasonable and safe manner for the position for which you have applied?
Have you ever received and AmeriCorps Education Award or been enrolled in an AmeriCorps program before?
Education and Training
Have you earned your HS Diploma or GED?*
Where did you attend High School?
Skills/Experience
Please describe volunteer or community service experiences you have had in the past:
Do you have any other skills, licenses, certificates and/or other qualifications you wish to mention? Please list:
Short Answer Questions
Please tell us why you want to become a member of Mile High Youth Corps:
A major part of the Mile High Youth Corps program involves learning about the environment and the community. What would you like to learn? Why?
What are your future career and education goals?
In what ways do you feel personally ready to provide leardership within the community and among your peers? Please describe and use concrete examples:
Commitment is an important value with Mile High Youth Corps. How will you draw on your personal experiences regarding commitment and apply those lessons to a term of service?
Verification
I affirm that all of the information provided in this application is true and accurate.*

Yes No
If I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired.*

Yes No
In processing my application for employment, I authorize MHYC and/or its agents to verify all answers, statements and information provided by me.*

Yes No
Should be Empty:

General Information

Employment History

References

General

Education and Training

Skills/Experience

Short Answer Questions

Verification