Visitors / Employees

Businesses

Considering Opening a Business here?

Business Assistance and Grants

Workforce Development

Graffiti Removal

Need Help Rehabilitating Your Property?

Landlord Network

Important Numbers

Residents / Students

Community Cleanups

Report a Nuisance Property

Need Vehicle Assistance?

Need a Walking Escort?

Recycling

Where Does UCD Clean?

Important Numbers

2014 Summer Jobs Program Online Application

Youth Employment Network Program Application

APPLICANT INFORMATION

Click here to name this section

First Name

Last Name

Street

City

Zip/Postal Code

Home Phone

xxx-xxx-xxxx

Mobile Phone

xxx-xxx-xxxx

Date of Birth

MM/DD/YYYY

Social Security Number

xxx-xx-xxxx

Gender

Are you a citizen of the United States?

If NO, are you authorized to work in the U.S.?

Have you ever been convicted of a crime?

If YES, convicted of:

How did you hear about the program? Please specify the person/organization:

DEMOGRAPHIC INFORMATION

What is your race/ethnicity?

Use CTRL for multiple choices

Are you of Spanish, Hispanic or Latino origin?

HIGH SCHOOL

High School Name

Current Grade Level

Current GPA

When will you finish high school? (You must be graduating in 2014 to qualify for this program.)

MM/DD/YYYY

Which degree will you receive?

Number of school days missed this year

MOST RECENT OR CURRENT WORK EXPERIENCE

Company Name

Phone

xxx-xxx-xxxx

Employer's Address

Supervisor's Name

Your Job Title

Hourly Wage

Full Time or Part Time?

May we contact your supervisor for a reference?

Are you currently working here?

Date of hire

MM/DD/YYYY

Date of exit

Reason for Leaving

If applicable, please explain why you left this job.

PROFESSIONAL REFERENCES - Please list two professional references: like a coach, teacher, or work supervisor

First Reference

Full Name

Relationship to you

Employer/School

Phone Number

xxx-xxx-xxxx

Address

Second Reference

Full Name

Relationship to you

Employer/School

Phone Number

Address

STATEMENT OF INTENT

Please tell us why you would be a good fit for the program. Include your career plans, whether you have enrolled in college already, and what type of work you like to do.

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. If this application leads to entry into the program, I understand that false or misleading information in my application or interview may result in my release from the program.

Signature

Please enter your full name

Today's date

Please attach a copy of your resume and report card.

Need assistance with this form?

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Global Nav

Visitors / Employees

Businesses

Residents / Students

2014 Summer Jobs Program Online Application

Youth Employment Network Program Application

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Global Nav

Visitors / Employees

Businesses

Residents / Students

2014 Summer Jobs Program Online Application

Youth Employment Network Program Application

Connect with us