Summer Youth Job Application 2023 - The Youth Employment Partnership, Inc.

Where did you hear about this opportunity?*

Please write the name of the agency/person if they referred you.

Contact Information

Name (First)*

Name (Last)*

Date of Birth*

Age*

Home Phone Number*

Email*

Enter Email Confirm Email

Please use your personal email address instead of your school email. School email often rejects our messages, and this is how we'll contact you.

Cell Phone Number*

If you don't have a cell number, use your home phone number

Parent / Guardian or Alternate Contact Name*

Parent / Guardian or Alternate Contact Phone Number*

Home Address*

Street Address Address Line 2 City State ZIP Code

What area of Oakland do you live or stay in?*

Education

What is the highest grade you will have completed as of June 2023?*

Are you behind on credits?*

Yes
No

Are you attending summer school in 2023?*

Yes
No

If yes, where are you attending summer school?*

write "N/A" if you are not attending summer school

What school will you attend this fall?*

write "none" if you will not be attending school this fall

Working at YEP

What kind of work are you interested in?

Are you interested in Environmental or Outdoor Crew-Based work?*

Yes
No

Are you interested in any of the following?*

Yes
No

Additional Services

We will not use any of this information to exclude you from participating in our programs. You may be eligible for additional services or jobs based on these criteria.

Are you currently on probation?*

Yes
No

Do any of the following apply to you?*

Yes
No

Other not listed?*

write "N/A" if you have nothing else to share

Payroll Eligibility

Do you have any of these documents?*

Social Security Card or Right to Work Card
Neither

Is there anything else you would like us to know?

Certification*

Agree

I certify that all of the above information is correct to the best of my knowledge.

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Name

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