• Newark Youth One-Stop Career Center WIOA Application

  • Hello Newark Youth Resident,

    The City of Newark WIOA (Workforce Innovation and Opportunity Act) & Newark Youth One-Stop Career Center Programs allow Newark youth residents to have an opportunity to experience the workforce, explore vocational training opportunities, obtain a GED and develop professionally.

    Please complete the following application in its entire duration.

    Click Next to start your application

  • New Jersey Intake & Initial Assessment Form

  • Today's Date:
     / /
  • Date of Birth*
     / /
  • Gender:*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Contact Preference:*
  • Ethnic Heritage:*
  • Race:*
  • Marital & Family Status (Choose all that apply)*
  • School Status:*
  • Education Level (Choose highest level only):*
  • Post-Secondary/Vocational/Associate High School Plus:*
  • How many years of post-secondary education have you completed?*
  • How many years of Vocational Training have you completed?*
  • How many years of post-secondary education have you completed towards receiving an Associate Degree?*
  • Employment Status:*
  • If employed, are you working?*
  • If not employed and homemaker:*
  • US Citizenship:*
  • Card Expiration Date:*
     - -
  • Individual with Disability*
  • Migrant Seasonal Farmworker:*
  • If yes, choose one.*
  • Farmwork Type:*
  • Selective Service (Males born or after 1/1/1960 only): If you are a male age 18 + and living in the U.S., then you must register with Selective Service. You must supply a Selective Service Registration Card OR Selective Service “Online Receipt” to officially complete your enrollment so that you are eligible for future employment opportunities. If you have not already registered, visit www.sss.gov.*

  • Housing: (Choose one)*
  • Do you have Military Service Experience?*
  • If yes, use DVOP Checklist*
  • Service Disability:*
  • Receiving Veteran's benefits or assistance?*
  • Are you a Military Spouse?*
  • Military Spouse- Are you:*
  • If active duty spouse, has your income been affected by spouse’s deployment?*
  • Offender Status: Have you been convicted of a criminal offense?*
  • Do you feel you have any barriers to employment including customs, practices or beliefs, which you wish to disclose?*

  • Click "Next" unless you need to save and submit later.
     

  • Employment Preferences

  • Work Week Preference:*
  • Employment Duration Preference:*
  • Date Available to Work:*
     / /
  • Shift Preference: Willing to work any shift?*
  • If No, which shift(s) would you prefer?*
  • Acceptable Job Locations (choose one):*
  • Are you currently or have been employed?*

  • Work History (Current/Last Employer):

  • Start Date
     - -
  • End Date (Leave blank if presently employed by employer listed):
     - -
  • Reasons for leaving:

  • Certificate/Special Licenses:

  • Issued Date
     / /

  • Driver's License

  • Do you have a drivers license?*
  • Type of Drivers License:*
  • Source of Transportation*

  • Endorsements:

  • I attest that the information provided is true and accurate any misrepresentation may be grounds for termination from program(s). I further understand that being determined eligible for services and/or training does not necessarily entitle me to service/training.

  • Date
     / /

  • Click "Next" unless you need to save and submit later.
     

  • NEWARK YOUTH ONE-STOP CAREER CENTER

    Workforce New Jersey Customer Registration Form
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • 17. School Status

  • 19. Are you receiving financial aid?
  • 20. Are you an EOF student?
  • 24. What year are you in?

  • I certify that the information above is true and correct to the best of my knowledge.

  • Date:
     / /

  • Click "Next" unless you need to save and submit later.
     

  • Newark Youth One-Stop Career Center Intake Assessment Form

  • Date:
     / /
  • Date of Birth*
     - -
  • Format: (000) 000-0000.
  • Gender*
  • What is your school status?*
  • Ethnic Background:*

  • Emergency Contact Person:

  • Format: (000) 000-0000.

  • Click "Next" unless you need to save and submit later.
     

  • Family Information & Household Income

  • Rows
  • Rows

  • Household Income:

  • What is your current source of income?*

  • How often do you receive income?*

  • Click "Next" unless you need to save and submit later.
     

  • Income Letter

    As an 18 year old and over, and currently not receiving income, you are eligible to sign our WIOA Self- Certification Income Letter. This letter will count as a form of proof of income.

  • I hereby certify, under penalty of perjury, that the following information is true.

  • I attest that the information stated above is true and accurate, and understand that the above information if misrepresented, or incomplete, may be grounds for immediate termination and/or penalties as specified by law.

  • Date
     - -

  • Click "Next" unless you need to save and submit later.
     

  • Family Health Information

  • What is your general health?*
  • Are you presently receiving any medical care?*
  • Does anyone in your family have health and/or mental problems?*
  • Does your medical treatment include the use of medications?*
  • Are you pregnant?*

  • Click "Next" unless you need to save and submit later.
     

  • Transportation Information

  • Do you have a driver's license?*
  • If not, are you interested in obtaining one?*
  • Do you have an expired or suspended license?*
  • Do you own a car?*
  • Do you have a monthly bus card or bus tickets?*
  • Are you in need of transportation assistance?*

  • Click "Next" unless you need to save and submit later.
     

  • Education Assessment/Job Training:

  • Did you graduate from High School?*
  • Date of Graduation*
     / /
  • If not a high school graduate, have you participated in a GED program?*
  • Are you in need of GED Training?*
  • Have you ever participated in a job training program(s)?*
  • Did you complete the training program(s)?*
  • Do you plan to further your education?*
  • Do you have any difficulties in school?*
  • Are you interested in enrolling in a work readiness program?*
  • Do you think you are capable of participating and completing the program?*
  • Are you ready to begin in the workforce?*
  • Have you attended any interviews in the past 6 months?*
  • Check the employability skills below you need to improve on*

  • Click "Next" unless you need to save and submit later.
     

  • Employment Information

  • What is your current employment status?*
  • Have you been employed previously?*
  • If employed, are you employed part-time or full-time?*
  • Are you a full-time or part-time student?*
  • Format: (000) 000-0000.

  • Click "Next" unless you need to save and submit later.
     

  • Personal Information

  • Have you ever used drugs or consumed alcohol?*
  • If yes, would you like to be referred to a substance abuse treatment program?*
  • Have you ever been sexually or physically abused?*
  • Have you ever received counseling for the abuse?*
  • Have you ever experienced any issues with domestic violence or child abuse?*
  • Have you ever had any involvement with DYFS?*
  • Have you ever been convicted of a crime of felony?*
  • Are you currently on probation?*
  • Do you have any pending or upcoming court dates?*

  • Future Goals

  • What are your short-term goals? Please list realistic & obtainable goals.

  • What are your five-year goals? Please list realistic & obtainable goals.

  • Click "Next" unless you need to save and submit later.
     

  • Documentation Submission

    In order to be fully assessed for Newark Youth One-Stop Career Center Programs, the following documentation below must be provided. If you do not have all the required documentation, you can submit to your counselor at a later date.

  • Documentation Checklist 

    ❏ Birth Certificate and/or Active U.S. Passport and/or Active Naturalization Card

    ** IF BORN OUTSIDE OF UNITED STATES, PLEASE PROVIDE

    NATURALIZATION CARD or VALID WORK PERMIT CARD

    ❏ Social Security Card

    ❏ Proof of Address- EXAMPLE: Any Bill, Bank Statement (Must Be Dated

    within the Last 60 Days) or Current Lease

    ❏ Income Verification (Three recent pay stubs, 2019 W2 Forms or Award Letter)

    ❏ Report Card or Diploma

    ❏ Resume

  • If you do not have a Printer Scanner, please watch the tutorials below on how to scan your documents using either an iPhone or Andriod Device.

    Android Users: Please first download Adobe Scan in Google Play & watch the Adobe Document Scan Tutorial

    iPhone Users: Watch Scan your Documents Tutorial

     
    Ensure that each documentation sent is clear and viewable.

    Upload your documents below.

  • Browse Files
    Cancelof
  • Browse Files
    Cancelof
  • Browse Files
    Cancelof
  • Browse Files
    Cancelof
  • Browse Files
    Cancelof
  • Browse Files
    Cancelof
  • Browse Files
    Cancelof
  • Browse Files
    Cancelof

  • Click "Next" unless you need to save and submit later.
     

  • Agreement

  • I realize that it is my obligation to assure that my attendance and performance in this program are in compliance with the rules and regulations of the Newark Youth One-Stop Career Center. I am aware that I am required to keep all appointments with my WIOA representative, maintain satisfactory performance and regular attendance. I will actively seek employment; achieve the needed goals as previously agreed upon with my WIOA representative. In addition, provide my WIOA representative with any new personal/contact information. I understand that participating in this program is not an entitlement and services are not guaranteed.

    My WIOA Representative will consistently provide guidance and assistance in reaching the goals outlined in this assessment. Any circumstances affecting the successful attainment of this plan will be discussed with my WIOA representative and any modification to this plan will be as a result of a mutual agreement.

  • Date:
     / /

  • Click "Next" unless you need to save and submit later.
     

  • Newark Youth One-Stop Career Center (Youth Information Release Form)

  • By filling out and signing this Release Form, I am giving The Newark Youth One-Stop Career Center (NYOSCC) permission to refer you to other agencies and services that they deem necessary to help in achieving their goal(s) and to receive information pertaining to their academic performance through the Newark School System and other programs as necessary. The Academic Performance information will include, but not limited to, copies of Report Cards, Progress Reports and Certificate of Completion from High School, and programs.

    This information will be requested by a designated representative from The Newark Youth One-Stop Career Center and will be used to update the student’s academic performance status, follow up, and/or additional services that were identified as the participants' needs and goals.

    I have read this release, understand all its terms, and execute it voluntarily and with full knowledge of its significance

  • Date of Birth:*
     / /
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Date
     / /

  • Click "Next" unless you need to save and submit later.
     

  • Newark Youth One-Stop Career Center (Image “Use” Authorization Form)

  • If your child is 14-17 years of age, please read and complete the form below:

     I,  the parent or guardian of 2020 SYEP youth participant understand that while I participate in the City of Newark Youth One-Stop Career Center’s Program, and any affiliates of the "The City of Newark" may take photographs, video, audiotape, and other image and sound-based media of program activities and its participants. The City of Newark may wish to use such photographs, video, audiotape, and other image and sound-based media for educational, promotional, advertising, and other purposes, without compensation or prior notice. 

     

    Therefore, I as a parent and/or guardian of 2020 SYEP youth participant hereby freely and voluntarily consent to the use and publication of my name, the 2020 SYEP youth participant name, participation picture, and/or likeness by the City of Newark and/or its employees and/or agents for any and all purposes including, but not limited to, educational, promotional, advertising and trade, through any medium or format, including, but not limited to, videotape, audiotape, film, photograph, television, radio, digital, internet, theater, or exhibitions, at any time from this date forward. I further waive any claims against the City of Newark and/or its employees and/or agents based upon or related to its use or publication of my likeness, voice, participation, and/or picture.

     

    I freely give this authorization without expectation of compensation. 

  • Format: (000) 000-0000.
  • Date
     / /

  • Click "Next" unless you need to save and submit later.
     

  • Newark Youth One-Stop Career Center (Image “Use” Authorization Form)

  • If you are 18-24 years of age, please read and complete the form below:

    I understand that while I participate in the City of Newark Youth One-Stop Career Center Program, and any affiliates of the "The City of Newark" may take photographs, video, audiotape, and other image and sound-based media of program activities and its participants. The City of Newark may wish to use such photographs, video, audiotape, and other image and sound-based media for educational, promotional, advertising, and other  purposes, without compensation or prior notice.

    Therefore, I hereby freely and voluntarily consent to the use and publication of my name, participation, picture, and/ or likeness by the City of Newark and/ or its employees and/or agents for any and all purposes including, but not limited to, educational, promotional, advertising, and trade, through any medium or format, including, but not limited to, videotape, audiotape, film, photograph, television, radio, digital, internet, theater, or exhibition, at any time from this date forward. I further waive any claims against the City of Newark and/or its employees and/or agents based upon or related to its use or publication of my likeness, voice, participation, and/ or picture.

    I freely give this authorization without expectation of compensation.

    I am 18 years of age or older, and I am competent to contract in my own name. I have read this release before signing below, and I fully understand the contents, meaning, and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.

  • Format: (000) 000-0000.
  • Date
     / /

  • Click "Next" unless you need to save and submit later.
     

  • The RIASEC Test

    Discover your potential career pathway here!

  • Follow these easy steps to see where your interests are! 

    Read each statement. If you agree with the statement, choose it. There are no wrong answers!

  • R= Realistic (Choose all that apply)*
  • I= Investigative (Choose all that apply)*
  • A= Artistic (Choose all that apply)*
  • S= Social (Choose all that apply)*
  • E= Enterprising (Choose all that apply)*
  • C= Conventional (Choose all that apply)*

  • Add up the numbers of checked boxes for each question and transfer the total score above for each letter to the appropriate box below for the grand total.

  • Take the three letters from above with the highest scores and record them into "My Interest Code" below. Your highest scores will allow you to explore Career Pathways that could be right for you!

  • *   *   *   

  • Click Next to see the RIASEC Career Pathways! 

  • RIASEC Career Pathways

    Based on the three letters with highest score, you can explore career pathways below that maybe suitable to you.

  • R = Realistic

    These people are often good at mechanical or athletic jobs. Good college majors for Realistic people are…

    • Agriculture
    • Health Assistant
    • Computers
    • Construction
    • Mechanic/Machinist
    • Engineering
    • Food & Hospitality

    Related Career Pathways

    Natural Resources

    Health Services

    Industrial & Engineering Technology

    Arts & Communication

  • I = Investigative

    These people like to watch, learn, analyze, and solve problems. Good college majors for Investigative people are…

    • Marine Biology
    • Engineering
    • Chemistry
    • Zoology
    • Medicine/Surgery
    • Consumer Economics
    • Psychology

    Related Career Pathways

    Health Services

    Business

    Public & Human Services

    Industrial & Engineering Technology

  • A = Artistic

    These people like to work in unstructured situations where they can use their creativity. Good college majors for Artistic People are...

    • Communications
    • Cosmetology
    • Fine & Performing Arts
    • Photography
    • Radio & TV
    • Interior Design
    • Architecture

    Related Career Pathways

    Public & Human Services

    Arts & Communication

  • S = Social

    These people like to work with other people, rather than things. Good college majors for Social people are…

    • Counseling
    • Nursing
    • Physical Therapy
    • Travel
    • Advertising
    • Public Relations
    • Education

    Related Career Pathways

    Health Services

    Public & Human Services

  • E = Enterprising

    These people like to work with others and enjoy persuading and performing. Good college majors for Enterprising people are

    • Fashion Merchandising
    • Real Estate
    • Marketing Sales
    • Law
    • Political Science
    • International Trade
    • Banking/Finance

    Related Career Pathways

    Business

    Public & Human Services

    Arts & Communication

  • C = Conventional

    These people are very detail-oriented, organized, and like to work with data. Good college majors for Conventional people are…

    • Accounting
    • Court Reporting
    • Insurance
    • Administration
    • Medical Records
    • Banking
    • Data Processing

    Related Career Pathways

    Health Services

    Business

    Industrial & Engineering Technology

  • Click "Next" unless you need to save and submit later.
     

  • Grievance Procedures

  • To protect your rights and privileges as a participant, a grievance procedure has been established to help resolve problems when a participant feels they have been treated unfairly. Participants are required to make every effort possible to resolve any problem they have with the Newark One-Stop Career Center staff. If a grievance has not been resolved to a participant’s satisfaction, write or contact directly:

    MARSHA ARMSTRONG, DIRECTOR
    NEWARK YOUTH ONE-STOP CAREER CENTER
    500 Broad Street; 3rd Floor
    Newark, New Jersey 07102
    Tel: (973) 273-6064

    Newark Youth One-Stop Career Center will investigate the matter and make a decision. If a participant is not satisfied with the decision, that participant will have 30 days to appeal in writing to:

    DAVETTA LANE, DIRECTOR OF OPERATIONS
    NEWARK YOUTH ONE-STOP CAREER CENTER
    990 Broad Street; 1st Floor
    Newark, New Jersey 07102
    Tel: (973) 733-8500

  • Date
     / /
  • Date
     / /

  • Click "Next" unless you need to save and submit later.
     

  • Click "SUBMIT" to fully submit your application
     

  • Should be Empty: