Young Adult Program Application 2024 - The Youth Employment Partnership, Inc.

Applicant's Contact Information

Name (First)*

Name (Last)*

Phone Number*

Alternate Phone Number

Email*

Enter Email Confirm Email

Date of Birth*

Age*

Gender*

Male
Female
Other
Decline to state

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

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Tell us more about yourself

Do you have a high school diploma or GED?*

High School Diploma
GED
Neither

From what school did you receive your diploma?*

Write “N/A” if you do not have a diploma or GED

Are you attending community college, where and what program?

Write “N/A” if you are not attending community college

Vocational Interests (please check all the apply)*

Construction
Culinary
Landscaping / Public Works
Warehouse
Other

If other, please list*

Write “N/A” if you did not select “Other”

Have you ever had a job?*

Yes
No

If so, where?*

Write “Never had a job” if you checked “no”

Have you ever participated in any job training program?*

Yes
No

If so, please list the names of all the programs you've been in*

Write “N/A” if you checked “no”

When did you participate?*

Enter months and year. If “no,” write “N/A”

Program Specifications

*Onboarding 1 week = $100 gift card completion bonus *2-week pre-Job Training = $400 completion bonus *Free lunch + free daily bus passes during Job Training *Weekly perfect-attendance bonuses = $25 in addition to completion bonus *After completion of Job Training, enter 10-week internship = up to $700 (gross)/bi-weekly

Are you eligible? (must check at least one box to be eligible)*

How else can we help you? (check all that apply)*

Please check all of the documents that you have:*

ID or Driver’s License
Social Security Card
High School Transcript or High School Diploma
Court/Probation documents (if applicable)

Note: you will need to bring these documents to start the program. We will help pay for your ID/Birth Certificate and help you get your Social Security Card

Tell us about your right to work in the U.S.

United States Citizen (born in the U.S.)
Citizen or applied for Citizenship
Valid/Current Alien Registration Card

Certification

By submitting this application, I certify that all of the above information is true and correct to the best of my knowledge.

Agree*

Today's Date*

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Name

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