Mayor's Summer Jobs Program 2023 Application

Application for Mayor's Summer Jobs Program 2023

Application must be submitted by 12:30 p.m. on April 28th, 2023.
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This form is not yet open. Please come back on or after April 4, 2022.
The application period for the Mayor's Summer Jobs Program has ended. Thank you for your interest!
Date of Application*

MonthDayYear
Date
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number (Required)*
Please enter a valid phone number.
Alternate Phone Number (Optional)
Please enter a valid phone number.
Email*
example@example.com
Are you eligible to work in the United States?*

YesNo

Emergency Contact Information
Emergency Contact Name*

First NameLast Name
Primary Phone Number (Required)*
Please enter a valid phone number.
Alternate Phone Number (Optional)
Please enter a valid phone number.
Relationship to You*
E.g. "Grandmother"

Special Opportunity for Somerville Youth Aged 14 to 15
There will be a limited number of spots to work within Parks & Recreation and other City departments for students aged 14 to 15. As part of the application process, you will need to have approval from a physician and a parent, guardian, or custodian to obtain a work permit.
Have you ever participated in the City of Somerville's Summer Jobs Program?*

YesNo
Where?*
When?*

Educational Status
I attend __________________ School.*
I am currently in the ___th grade. (Enter # below)*
Please list your volunteer history and any clubs/activities you are involved with:
Do you speak any languages other than English? If so, please list them:
Have you completed any job readiness programs (such as CIT/LIT)? If so, please list them:

Employment History
Have you held any jobs in the past?*

YesNo, this will be my first job
Job 1*

Job 2 (If applicable, or press 'Next' to skip)
Job 3 (If applicable, or press 'Next' to skip)

Where Would You Like to Work?

Please indicate your work location preferences by rearranging the options below. This does not guarantee where your worksite location will be, but it gives us an idea of what your interests are.
Worksite Preference (Click & drag to reorder)*
References

Please give the name and telephone number of two adult references that are not related to you and are not previous employers (i.e. neighbor, sports coach, guidance counselor, or other school staff).
Reference 1*
Reference 2*
Applicant's Statement

Please read and sign below:

I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. The applicant understands that neither this document nor any offer of employment from the employer constitutes an employment contract unless the employer and employee in writing to that effect execute a specific document. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
Signature certifying the above statement:
Signed On

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Voluntary Survey (Optional)

Government agencies at times require periodic reports on the sex, ethnicity, handicapped, veteran, and other protected status of applicants. This data is for analysis and possible affirmative action only. SUBMISSION OF THIS INFORMATION IS VOLUNTARY.
Please select the options that apply to you:

FemaleMaleGender Non-ConformingHispanic/LatinoWhiteBlack or African AmericanAmerican Indian/Alaskan NativeAsianNative Hawiian/Pacific Islander'Two or More Races
Should be Empty:

Application for Mayor's Summer Jobs Program 2023

Emergency Contact Information

Special Opportunity for Somerville Youth Aged 14 to 15

Educational Status

Employment History

Where Would You Like to Work?

References

Applicant's Statement

Please read and sign below:

Voluntary Survey (Optional)