MUST Read Important Instructions

Transcription

1 Welcome! MUST Read Important Instructions The application will CLOSE at 5:00 P.M. on April 12, You can only apply Once. You are beginning your application for CareerSource Polk's Summer Youth Employment Program. Please note that once you start the application process, you will NOT be able to save your work. We suggest that you print preview by clicking here prior to starting this application. If you have any questions, refer to the Frequently Asked Questions page. You can view that by clicking here. If you are ready to complete this online application, click on the "Next" button below. Please note that questions with an asterisk (*) are required to be answered in order to complete the application. 1

2 Eligibility Information * 1. First Name * 2. Last Name * 3. Age 15 or Younger or Older 2

3 Education Status The following questions will ask you about your current educational status. * 4. What is your current education status: Attending high school Attending adult school Attending College or Technical School Out of School (not attending any school) 3

4 Education Status: High School The following questions will ask you about your current educational status. Please use "N/A" for questions that do not apply to your situation. * 5. Enrolled in High School Current School Name Current Grade Level Last Grade Successfully Completed Anticipated Graduation Date 4

5 Education Status: Adult School The following questions will ask you about your current educational status. Please use "N/A" for questions that do not apply to your situation. * 6. Enrolled in Adult School Current School Name Last Semester Successfully Completed Anticipated Graduation Date 5

6 Education Status: College or Technical School The following questions will ask you about your current educational status. Please use "N/A" for questions that do not apply to your situation. * 7. Which are you currently attending? College Technical School * 8. Enrolled in College or Technical School Name of Institution Date of enrollment Length of Program (In Years) 6

7 Education Status: Out-of-School The following questions will ask you about your current educational status. Please use "N/A" for questions that do not apply to your situation. * 9. Not enrolled in any school Name of Last School Attended Highest Grade Level Completed Did you drop out? Do you have a high school diploma or GED? 7

8 Personal Information The following questions will ask you about your personal information. * 10. Street Address Address Address 2 City/Town State -- select state -- ZIP * 11. Date of Birth (Format: MM/DD/YYYY) MM/DD/YYYY * 12. Social Security Number (Format: XXX-XX-XXXX) * 13. Gender Male Female 8

9 * 14. Marital Status Single, Never Married Married Living with Partner Separated Divorced Widowed Prefer Not to Answer * 15. Citizenship Status US Citizen Permanent Resident Alien Other (Please Specify) * 16. Race/Ethnicity Caucasian Black or African American Hispanic or Latino American Indian Asian Native Hawaiian or Other Pacific Islander Mixed or Multiracial Other 9

10 Contact Information The following questions will ask you about your contact information. * 17. Address * 18. Phone Number (Format: XXX-XXX-XXXX) Main Alternate/Cell Phone * 19. Emergency Contact First Name Last Name Phone Number (XXX-XXX-XXXX) Relationship to Applicant 10

11 Additional Background Information The following questions will ask you for your additional background information. * 20. Are you pregnant or have any children? No Yes (Please Indicate the Number of Children) * 21. Are you a current Young Leaders participant? Yes No * 22. Have you participated in a CareerSource Polk Young Leaders program before? No Yes (Please Specify the year and the location) * 23. Did you attend the 2019 What's Next Expo on March Yes No 11

12 * 24. Please answer the following questions below. Yes No Is English your second language? Are you registered with Selective Service? Are you a runaway? Are you currently homeless or living in a shelter? Are you or have you been a foster child? Have you ever been arrested or convicted of a crime? Are you a veteran of the U.S. Armed Forces? Are you the spouse or child of a veteran or active duty member of the U.S. Armed Forces? * 25. Do you have a disability? No Yes (Please Specify Any Accommodations You May Need in the Worksite) 12

13 Employment Information The following questions will ask you about your employment status. * 26. Are you currently employed? Yes Never Worked No (Please Provide Last Day Worked (Format: MM/DD/YYYY)) 13

14 Employment Information - Previously Worked The following questions will ask you about your current or most recent employment. * 27. Rate of Pay (Per Hour) (Format: XX.XX) * 28. Total Hours Per Week * 29. Total Number of Weeks Employed 14

15 Family Information The following questions will ask you about your family. Definition of Family: Anyone related by blood, marriage, or decree of court. This includes parent(s), sibling(s), guardian(s), and dependent child(ren) ONLY. * 30. Please check if you or your family has received any of the following in the past six months below. Cash Assistance or TANF Food Stamps SSI/SSD Unemployment General Assistance Transitional Needy Free or Reduced Lunch None Other (Please Specify) * 31. Total Number of Family Members in Household * 32. Total Family Income (Gross) for the Last Six Months (Include all individuals who work. If you are uncertain, please use "0.") 15

16 * 33. In the past six months, has the primary wage earner been laid-off? No Yes (When? If Unsure, Enter "N/A" (Format: MM/DD/YYYY)) * 34. Does the applicant have reliable means of transportation? Yes No 16

17 Areas of Interest and Availability The following questions will ask you about your areas of interest. Think about the following career pathways and select any three below that would be interesting to you. Please note that placement in your areas of interest are not guaranteed. * 35. Areas of Interest First Choice Second Choice Third Choice Childcare/Adult Daycare Clerical Computers/IT Customer Service Education Food Service/Hospitality Government Insurance Manufacturing/Logistics Outdoor/Maintenance Recreation/Day Camp Retail/Sales Warehouse 36. List any after-school or community programs you are involved with below. 17

18 * 37. What days are you available to work during the months of June 3, August 9, 2019? Monday Tuesday Wednesday Thursday Friday Saturday Sunday * 38. What times are you available to work during the months of June - August? Morning (8:00 a.m. to 12:00 p.m.) Afternoon (12:00 p.m. to 5:00 p.m.) Evening (5:00 p.m. to 10:00 p.m.) * 39. What area(s) of Polk County are you able to work? Bartow Fort Meade Frostproof Haines City Lakeland Lake Wales Mulberry Winter Haven Other (Please Specify) 18

19 Thank You for submitting your application! Thank you for your application to the Youth Employment Program. All applicants will either receive an or a phone call from staff with an scheduled appointment for the Summer Youth Employment Program (SYEP) orientation which includes an overview of the Summer Youth Employment Program and completion of the new hire paperwork. All participants must be available to take the drug screening and background check in order to participate in SYEP. Upon completion of the screening process, youth will be scheduled an eligibility appointment, where they will be required to bring all requested documents needed for eligibility. Please be patient and do not call CareerSource Polk to ask if you are in the program, wait for our staff to contact you. You can always visit our website for updates services. In the meantime, you should begin gathering the documents that you will need IF you are selected to participate in the program. These include: Social Security card (If you need to apply for one, please note that it takes at least two weeks to receive your card.) Current photo id ( Acceptable IDs: Florida driver's license, Florida ID, US passport, or Alien Registration Card) Proof of income for the last six months for your household (Examples of acceptable documents: paystubs, public assistance, social security) Documentation of Polk County residency (Examples of acceptable documents: lease agreement, utility bill, or letter from Social Service Agency) Documentation to validate last school attended. (Examples of acceptable documents: high school or college diploma, current transcript, school summary sheet, or withdrawal documentation) You must present original documents at your eligibility appointment. Copies will NOT be accepted. If you meet the eligibility requirements to completed second stage of the enrollment process, CareerSource Polk will notify you of an appointment date. You must personally appear for this appointment and bring with you all required documents. If you do not bring all the documents required to your eligibility appointment, it will delay the process of your application, and you may lose your slot. 19