Mayor's Youth Academy Career Coaching Application
Full Name
*
First Name
Last Name
Address
*
Street Address
Apt./Unit Number
City
State
Zip Code
Personal Email Address
*
Not Your School Email Address
Personal Phone Number
*
-
Area Code (***)
Phone Number
Date of Birth
*
-
Month
-
Day
Year
Date
What School Do You Attend?
*
Example High School
Ethnicity
*
African American
Asian
Bi-Racial
Hawaiian or Pacific Island
Hispanic
Multi-Racial
Native-American
Caucasian
Other
Parent/ Guardian Name
First Name
Last Name
Parent/ Guardian's Phone Number
-
Area Code (***)
Phone Number
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Highest Level of Education Received?
*
Did Not Complete High School
GED
Technical Certificate
Special Education Certificate
High School Diploma
Associate's Degree
What Are You Seeking?
*
Part-Time Employment
Full-Time Employment
Career Exploration (Resume, Career Searching, Interviewing)
Training
If You Selected Training, List What Type of Training You're Interested In
What Are Your Career Interest?
*
Entertainment, Arts, Recreation
Accommodation and Food Services
Health Care and Social Assistance
Transportation and Warehousing
Educational Serivces
Professional, Scientific and Technical Services
Administrative Support and Waste Management and Remediation Services Information
Finance and Insurance
Wholesale Trade
Management of Companies and Enterprises
Real Estate and Rental and Leasing
Other
How comfortable are you with job searching?
1- Very Uncomfortable
2-
3-
4-
5-
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Do you currently have a resume?
*
Yes
No
If you have a resume, please upload your resume.
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Are you currently Employed?
*
Employed
Unemployed
Have Never Held A Job
If you are currently employed, on average, how many hours do you work weekly?
If you are currently employed, what is your hourly wage?
Employment History: Please List Your Last Two Jobs and Include a Few of Your Job Duties
If applicable, if not then list N/A
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