2022 Summer Employment Program Application

2022 Summer Employment Program Application
Eligibility

You MUST complete the application in full and be 14-19 years old as of June 21, 2022. Additionally, the attached application surveys MUST be completed to be considered for the program. Priority will be given to applicants who meet one or more of the following criteria:
- Having one or more disabilities
- Poor school performance
- Teen parenthood
- Living in a household that receives public/government assistance (section 8, food stamps, etc.)
- Living in a neighborhood with high poverty rates
- Involvement in the juvenile justice system
- Past or present victim of crime
- Living in foster care or a group home
- Without a permanent home
Complete application no later than April 7, 2022

Application Submission

Requirements

•       Only completed applications (with signatures and required documents) will be accepted.

•       Completed applications are not guaranteed acceptance into the Summer Employment Program.

After Acceptance

If you are accepted into the Summer Employment Program, you will need to present original legal documents proving your work eligibility during your orientation. We will require you to show the following:

•       Original Social Security Card or certified Birth Certificate

•       Photo ID (Current State ID, Current School ID, SF City ID Card, Permanent Resident Card, passport)

If you do not have these documents, you should start the process of obtaining them ASAP:

•       Social Security Office: (866) 964-6227

•       NC State ID: (910) 251-5747

•       Birth Certificate: please contact the hospital in which you were born

Application Checklist

Only completed applications will be accepted. Please double-check that you meet all eligibility requirements and have followed all directions before submitting your application.
Program Eligibility *

I will be 14 to 19 years old before or by June 21, 2022. I am eligible to work in the United States.
Additional Documents *

I will submit a copy of documents that show Proof of Age before the program starts
Submission *

I am turning in the application before April 7, 2022. I have started to gather my work eligibility documents.
Personal Identification
Name *

First Name Middle Name Last Name
Date of Birth *

Month Day Year
Date
Age *
Home Address *
Home Phone Number
Cell Phone Number *
Email Address *
Parent/Guardian Information
Name of parent or guardian *
Relationship *
Parent/guardian phone number *
Occupation *
Demographics
Have you been in the Summer Employment Program before? *

Yes No
Did you fail Math or English class this year? *

Yes No
Have you ever had a job before *

Yes No
Did you have the job in the last 3 months? *

Yes No
Name of School *
Current GPA *
On a 4.0 scale
Current Grade Level *

9th 10th 11th 12th Graduated
Projected High School Graduation Date *
Month and Year
Activities (Sports, Clubs, Groups, Programs) *
Gender *

Female Male Transgender
English Proficiency *

Fluent Somewhat Fluent Not Fluent
Other (Mark all that apply)

Disabled LGBTQ I financially support my family I am a parent
Do you have an Individualized Education Program (IEP)? *

Yes No
Reason for IEP

If you have been involved in the Juvenile Justice system, please indicate below. Additionally, if you have a case manager for school (which includes IEP), please indicate below

	I have a Probation Officer	Name	Phone Number
Juvenvile Justice

	I have a Case Manager	Name	Phone Number
Case Management

Where Do You Live (Please mark all that apply) *

Family Group Home Single Parent Household Homeless Foster Home Self-Supported
Race/Ethnicity (Check all that apply) *

Black or African American Native Hawaiian or Other Pacific Islander American Indian or Alaska Native Hispanic Latino/Latina Asian White
Check if any of the following apply: Have you ever

been threatened with bodily harm had anything taken or stolen from you been a victim of another crime been bullied (physical, verbal, or cyber (on phone or text, social media, or on the computer) had family violence in your home been jumped, hit or physically harmed by someone been stalked or harassed
Home Language
Do you speak a language other than English in your home? If so, what language do you speak?
If you speak English at home, please leave this section blank
Family Income Information

Please have your parent/guardian assist you in completing this section.
The following forms of government assistance/programs are received by anyone in my household (check all that apply):

TANF Food Stamps SNAP SSI Public Housing
How many people live in your household *
How many people in your household have full time employment? *
What is the combined approximate total annual income of everyone in your household? *
Summer Schedule

Please write in any weekly commitments you will have this summer (including summer school, sports, music, lessons, counseling, classes, babysitting, religious commitments) and the time you are committed to attend. For example, write "Summer School 8am - 12pm" or "Take care of my brother 3pm - 4pm."

Please fill out your Summer Schedule, if you have weekly commitments.

	Monday	Tuesday	Wednesday	Thursday	Friday
Summer Schedule

Extra Information
Are there any neighborhoods or areas you do not feel comfortable or safe in?
Have you thought about a career that interests you? *

Yes No
What is your career goal or desired occupation? *
Mode of transportation to worksite *

Private vehicle Public Transportation Walking Biking
Do you have any physical disabilities or require any special accommodations to complete tasks?
Youth Commitment
By signing below, you are acknowledging the following:

•       All the information provided is true to my knowledge.

•       I am committing to attend all workshops and working all of my scheduled hours this summer.

•       I am aware that I will be expected to exhibit professionalism, punctuality, and responsibility throughout the program.
Youth Signature *

Clear
Date

Month Day Year
Applications are due to Voyage staff or designated school officials no later than April 7, 2022. If you have any questions about this application or the Summer Employment Program, please feel free to contact Program Director, Cordia Sloan at cordia.sloan@voyagewilmington.org or Workforce and Education Coordinator, Jessica Petty at jessicapetty.voyage@gmail.com Applications may be delivered to the Voyage office at the Hemenway Center at 507 McRae Street between 9:00-5:00 Monday- Friday.

2022 Summer Youth Employment Program Application Surveys
Work Skills Youth Assessment 2022
On a scale of 1-4, with 1 being minimal/none, 2 – below average/somewhat, 3 – above average/good, 4 – excellent/strong, please circle your opinion of your current work skills:
Computer Skills *
Problem-solving Skills *
Public Speaking Skills *
Accepting Supervision *
Financial Management Skills *
Importance of Career *
Communication Skills *
Organization *
Reporting to Work on Time *
Dressing Appropriately for Work *
Completing Assignments on Time *
Asking for Help *
Being Responsible *
Using Numbers *
Other (Please write):

2022 Summer Employment Program Application

Personal Identification

Parent/Guardian Information

Demographics

Home Language

Family Income Information

Summer Schedule

Extra Information

Youth Commitment

2022 Summer Youth Employment Program Application Surveys

Work Skills Youth Assessment 2022

Developmental Assets Profile

Career Clusters Interest Survey

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