MYA FORWARD INTEREST FORM
ABOUT MYA FORWARD
MYA Forward offers a unique opportunity for youth, ages 18-24, to participate in job training and gain credentials in high demand industries throughout the Greater Richmond area. Advanced training options include healthcare, technology, construction, and human services. Increase your earning potential, learn new skills, and gain valuable work experience with a team of workforce professionals ready to take the next step forward with you!
Personal Information
Full Name
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First Name
Middle Name
Last Name
Date of Birth
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Month
-
Day
Year
Date
Age
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Contact Information
Phone Number
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E-mail
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example@example.com
City of Richmond Resident?
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Please Select
Yes
No
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tell Us About Yourself
We want to get to know you. Please answer the following questions.
Describe yourself in 2-3 sentences.
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Education
Did you graduate from high school?
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Please Select
Yes
No
Are you currently enrolled in school?
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Please Select
Yes
No
Have you previously participated in Mayor's Youth Academy (MYA) programming?
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Please Select
Yes
No
Work Experience
Do you have previous work experience?
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Please Select
Yes
No
Are you currently employed?
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Yes
No
Your Interests
What are your short-term and long-term career goals?
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Which MYA Forward program services are you most interested in?
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Job Training Opportunities
Earning Certifications/Credentials
Paid Work Experience
Career Development Sessions
Other
Select up to 2 career fields that you are most interested in:
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Healthcare
Information Technology (IT)
Direct/Human Services (Such as Child Care, Customer Service)
Skilled Trades (Such as HVAC, Electrical, Plumbing)
Landscaping/Construction
Other
Have you received any formal training or certifications related to your desired career field?
Yes
No
This program will be hybrid (in-person and virtual attendance requirements). Do you have the ability to meet in-person up to 3 times for about 4 hours?
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Yes
No
Do you know about jobs available in the career field you're interested in?
Yes
No
Do you have access to transportation or are willing to take advantage of free transportation resources if needed?
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Yes
No
Do you have access to reliable internet?
Yes
No
Since most of this program will engage virtually, do you have access to a laptop or personal computer?
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Yes
No
Please indicate which times of the day you are available to participate in the program. (Select all that apply)
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Morning
Mid-day
Evening
Will you be able to start this program between March and April 2024?
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Yes
No
What challenges or barriers may impact your ability to fully participate or complete training?
Please Select
Transportation
Childcare/family related
Work Schedule
Other
Personal Motivation
The next few questions will ask for a response based on a 1-5 scale. 1= least likely or least willing and 5= most likely or most willing
If currently unemployed, what's tough about finding a job for you?
What do you think are your strengths and weaknesses in a professional setting?
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Please feel free to add any additional notes and/or helpful information
The primary goal of this program is to help individuals establish a career beyond their participation in the program. On a scale from 1-5, how likely are you to take advantage of 12 weeks of paid work opportunities?
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Least likely
1
2
3
4
Most Likely
5
1 is Least likely, 5 is Most Likely
On a scale from 1-5, how likely are you to take advantage of up to 12 weeks of training and education programs that lead to career advancement?
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Least likely
1
2
3
4
Most likely
5
1 is Least likely, 5 is Most likely
Being in a professional work environment can be challenging sometimes whether that be working with customers, teammates, supervisors, or difficult projects. On a scale from 1-5, how willing are you to put forth the effort necessary to grow as a professional?
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Least likely
1
2
3
4
Most likely
5
1 is Least likely, 5 is Most likely
Choosing a career and working towards long term goals can be challenging sometimes. On a scale from 1-5, how willing are you to put forth the effort necessary to achieve your goals?
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Least likely
1
2
3
4
Most likely
5
1 is Least likely, 5 is Most likely
On a scale from 1-5, how willing are you to get out of your comfort zone to try or experience new things?
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Least likely
1
2
3
4
Most likely
5
1 is Least likely, 5 is Most likely
Submit
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