2019 Summer Youth Employment and Learning Program

2019 Summer Youth Employment and Learning Program Pre-Application Form

Before you begin the 2019 Summer Youth Employment and Learning Program application process:

Do you have an email address?

You must provide a personal email address to complete this online survey. This is so we can send you program information and updates. All communications will be via email, so it is important that you give us your email address. If you do not have an email address, you need to create one before beginning your preapplication. You can create a free one online through websites like:

Sample email: firstname.lastname@gmail.com

What is your email address?

You must live in Capital Workforce Partners' region to be eligible for our program

Do you live in Connecticut?

Yes

You must live in Capital Workforce Partners' region to be eligible for our program.

What town do you live in?

Please select your provider.

Which provider are you applying through?

Please note: If you are Hartford resident and a rising college sophomore, you must choose Our Piece of the Pie as your provider.

Please provide as much contact information as possible. If we cannot reach you, you may miss your chance at an interview.

What is your name? (please capitalize)

What is your date of birth?

What is your address? (P.O. boxes not accepted)

What is your primary telephone number? (no dashes or spaces please)

Do you have an alternate phone number? (no dashes or spaces please)

Please provide contact information for your parent/guardian. You can also enter information for an alternate contact.

What is your parent/guardian's name and phone number?

What is your parent/guardian's email address?

Is there another person we can contact if we cannot reach you or your parent/guardian?

What is your alternate contact's email address?

Please provide some information about yourself.

What is your gender?

What gender do you identify with?

What is your race/ethnicity?

Are you Hispanic or Latino?

What is your work eligibility status?

Please provide some career information about yourself.

Have you ever had an internship or job before?

Do you have a resume?

What is your career interest?

Please provide some academic information about yourself.

Are you currently in school?

What school do you currently attend?

What is your current grade?

How many unexcused absences have you had this year?

We have several sources of funding for our summer program. This information helps us match you to eligible funding.

Do you currently receive free or reduced lunch?

Free

Reduced

None

Does someone in your household currently receive food stamps? (SNAP)

Does someone in your household currently receive state cash assistance? (TFA)

Do you have an active DCF case?

If you currently have an active DCF case, please provide information on your DCF social worker.

Did your social worker refer you to this program?

What is your social worker's name and phone number?

What is your social worker's email address?

We have several sources of funding for our summer program. This information helps us match you to eligible funding.

Are you currently pregnant or a parent?

Have you ever been involved with the court or justice system?

If you are male and 18 or older, have you registered for Selective Service?

Are you currently working?

Please verify that you are a human by checking the box below:

PLEASE NOTE: Your preapplication is not submitted until you click the "Submit My Preapplication" button below.

WHAT HAPPENS NEXT?

You will get an email confirmation that Capital Workforce Partners has received your online pre-application. All program updates will be emailed to you and also posted on our website (www.capitalworkforce.org).

Thank you for completing this survey, and for your interest in the Summer Youth Employment and Learning Program.
YOUR PREAPPLICATION IS NOT SUBMITTED UNTIL YOU CLICK THE "SUBMIT MY PREAPPLICATION" BUTTON BELOW.