Y.E.S. FORWARD INTEREST FORM
Youth Engagement Services Older Youth Program
ABOUT Y.E.S. FORWARD
Y.E.S. 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
*
First Name
Last Name
Are you between 18-24 years old?
*
Yes
No
City of Richmond Resident?
*
Please Select
Yes
No
Are you a City of Richmond resident?
*
Yes
No
What is your household income range?
*
Below $25,000
$25,001-50,000
$50,001-$75,000
Above $75,000
Date of Birth
*
-
Month
-
Day
Year
Date
Age
*
Contact Information
Preferred Contact Method
*
Phone Call
Text
Email
Phone Number
*
E-mail
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next
Readiness for Work & Motivation
We want to get to know you. Please answer the following questions.
How ready do you feel to enter the workforce?
*
Not Ready
1
2
3
4
Very Ready
5
1 is Not Ready, 5 is Very Ready
What would help you feel more prepared for work? (Select all that apply)
*
Resume writing & interview skills
Learning how to communicate with others (ex: supervisors/co-workers)
Understanding workplace expectations & professionalism
Managing time & balancing work responsibilities
Hands-on experience before starting a job
Financial Literacy (Budgeting, Understanding Paychecks, Savings)
Digital & Tech Skills (Email, Software, Spreadsheets)
Other
Which skills would you like to develop further to feel more prepared for work?
Communication
Time Management & Organization
Problem-solving & Critical Thinking
Resume Writing & Interview Prep
Leadership & Teamwork
Customer Service & Relationship Building
Digital & Tech Skills (Email, Spreadsheets, Software)
Financial Literacy (Budgeting, Understanding Paychecks, Savings)
Other
What would help you feel more prepared for work?
*
Did you graduate from high school?
*
Please Select
Yes
No
Do you have previous work experience?
*
Please Select
Yes
No
Are you currently working or in school?
*
Please Select
Yes
No
Have you previously participated in Youth Engagement Services programming?
*
Please Select
Yes
No
Work Experience
Are you currently employed?
*
Yes
No
Career & Program Interest
What are your short-term and long-term career goals?
*
How did you hear about Youth Engagement Services (Y.E.S.) Forward program?
Please Select
Social Media
Friend/Family
Referral
Website
Staff Member
What do you hope to gain from Y.E.S. Forward Program?
*
Job Training Opportunities
Earning Certifications/Credentials
Paid Work Experience
Career Development Sessions
Mentorship
Other
Select up to 2 career fields that you are most interested in:
*
Healthcare
Information Technology (IT)
Direct/Human Services (Such as Child Care, Customer Service)
Skilled Trades (Such as Construction, HVAC, Electrician, Plumbing)
Business & Office Administration
Entrepreneurship
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?
*
Yes
No
Do you know about jobs available in the career field you're interested in?
*
Yes
No
Do you have access to reliable internet?
Yes
No
Availability & Barriers
This program lasts up to 16 weeks, combining career training and paid work experience. Are you available to participate?
*
Yes
No
Need More Information
Do you have stable housing?
*
Yes
No
Do you have reliable transportation to attend training and work placement?
*
Yes
No
Sometimes
What is your primary mode of transportation?
*
Personal Vehicle
GRTC Bus
Lyft/Uber
Walking
Rely on family/friends for rides
Do you need support with any of the following? (Select all that apply)
*
Transportation
Digital Access (Internet, Laptop)
Childcare
Housing
Resume & Interview Prep
Professional Attire
Other
What is your preferred language for communication?
*
Please Select
English
Spanish
Other
Do you need language support for program participation? (Select one)
*
No, I am comfortable communicating in English.
Yes, I prefer receiving materials and support in Spanish.
Yes, I need support in another language.
Other
What additional support services would help you participate successfully in this program?
Please indicate which times of the day you are available to participate in the program. (Select all that apply)
*
Morning
Mid-day
Evening
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?
*
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?
*
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?
*
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?
*
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?
*
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?
*
Least likely
1
2
3
4
Most likely
5
1 is Least likely, 5 is Most likely
Back
Next
What's the best way to reach you to discuss next steps?
*
Call
Text
Email
Any other details you'd like to share? (Optional)
Submit
Should be Empty: