Summer Work Experience Opportunity (SWEO) Internship Application

Summer Work Experience Opportunity (SWEO)
Internship Application

Name

School

Grade

GPA

Are you on track to graduate?

Work Experience you are applying for

Career / Field of Interest

Home Address

Zip Code

Neighborhood

Phone

Will you be 18 on or before 6/6/2024?

Any known food allergies?

School Email

Personal Email

Are you a JCG city wide officer?

If "Yes", what is your title?

Do you currently have an Individualized Education Plan? (Answering “Yes” does not disqualify you from the SWEO Program)

Do you have a 504 plan? (Answering “Yes” does not disqualify you from the SWEO Program)

Is English your first language?

If "No", please enter your first language:

Check the identification documents you currently have:

Are you WIOA certified?

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Relationship

Do you currently have a mentor?

Mentor Name

Mentor Professional Title

Program Affiliate

If you will be involved in Summer Scholars or any other summer programming, please provide dates/times/schedule below:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Do you have vacation, post-secondary, or other summer plans that will conflict with the SWEO Internship schedule? If so, please explain and provide dates

What is your transportation plan for internship:

If Other - Please explain

Some of our partner sites may required drug testing; will this be an issue?” (Answering “yes” does not disqualify you from this opportunity):

Some of our partner sites may require a background check. Employment may be subject to successfully passing the check. Please initial that you have read and agree with this statement:

Have you ever been suspended or expelled?

If so, please explain

Do you have a criminal record or have you been through the justice system?

If so, please explain

Do you have children?

If you are currently working, what is your work schedule? Please type the start and end times that you work (eg 8am-5pm)

Employer

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

If you have past employment experience, list your job title(s), employer(s), and dates employed; if the employment was for a summer job only, indicate “summer” for the dates.

Job Title 1

Employer 1

Dates 1

Job Title 2

Employer 2

Dates 2

Please attach a copy of your resume in Word format (doc, docx).

Reference (Non-JCG Affiliate):

Name

Phone

Title

How long have you known them?

I authorize CYC’s representative to contact my reference. Please initial that you have read and agree with this statement:

An in person interview will be communicated to you by your JCG Specialist. For any questions, please contact Ms. Rabina Anand, Workforce Engagement Manager at ranand@cycyouth.org.