Name
*
First Name
Last Name
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Phone Number
*
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you between the ages of 16-24
Yes
No
Are you currently enrolled in school?
*
Please Select
Yes
No
Current Educational Status:
*
Please Select
High School
College
Vocational Training
Graduate
What is your Industry of Interest
*
Technology
Food Industry
Construction & Labor
Content Creation
Customer Service
Healthcare
Education & Training
Creative Arts
Environmental Green Jobs
Sports Recreation
Driving
Other
Are you willing to work remotely?
*
Yes
No
Why are you interested in participating in this employment program?
*
What are your career goals?
*
Do you have legal permission to work in United States
*
Yes
No
How many hours per week are you available to work?
*
0-10 hours
11-20 hours
21-30 hours
31-40 hours
More than 40 hours
Are you able to commit to a job for the entire summer?
*
Yes
No
What days are you available to work?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
During what times are you available on those days?
*
Mornings (6 AM - 12 PM)
Afternoons (12 PM - 5 PM)
Evenings (5 PM - 10 PM)
Late Night (10 PM - 6 AM)
Are your availability times flexible or fixed?
*
Flexible
Fixed
If offered a position, how soon are you able to start?
*
Immediately
Within a week
Within a week
Specific date (provide a field to enter a date)
Would you be open to working overtime if needed?
*
Yes
No
How do you prefer to be contacted for last-minute shifts or changes in schedule?
*
Phone Call
Text Message
E-mail
Other
How were you referred to us?
*
Facebook
Community Organizationl
Parent
Facebook
School
Word of Mouth
Other (please specify)
Resume and Files
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References
Please list one (1) references that are familiar with your work life.
Reference
By signing below, I confirm that all information provided in this application is true and accurate to the best of my knowledge. I understand that any false statements or deliberate omissions may disqualify me from consideration for employment or result in termination if discovered after hiring. I also acknowledge that this application does not guarantee employment.I have reviewed my availability as stated above and commit to maintaining this availability should I be selected for employment, understanding that consistent availability is crucial to my success in the program.
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