Training Application

Academy Application

For Pivot Charter School Students
Class Dates and Times

Dates: April 8 - May 29, 2025

Days: Tuesdays and Thursdays

Time: 12:30 pm - 2:30 pm

Location: Pivot Charter School

Lunch and Drinks Will Be Provided
General Interest Questions

This application helps determine the eligibility and needs of the participant. It will take approximately 10-15 minutes to read the acknowledgement and complete the application.
Eligibility

There are two pre-requisites for the program: (1) applicant is 16-24 years of age and (2) applicant is on track to graduate from high school or already possess a diploma/GED.
How did you hear about NextGen Trades Academy?*

School/College (select option on next question)Community Organization (Ex. Afterschool Program)Program GraduateFamily/FriendOnline (Facebook Ad or Other Marketing)Other
If you answered school or college, please make a selection below
Why do you want to join the NextGen Trades Academy? (check all that apply)*

Learn About ConstructionGet Safety CertificationsCreate and Build ThingsGet Some Work ExperienceGet a Full-Time JobPlan a Construction Career
How soon are you looking for full-time work after graduating from the program?*

30 days or less30-90 days90 days or longerI'm unsure
Please select the top 3 subjects that you're interested in*

Agriculture/Natural BuildingArchitectureBlinds/ShuttersCarpet CleaningCarpentryDraftingElectricalFinanceFlooringGreen Building/TechnologyGuttersHVACInterior DesignLandscaping/Landscape DesignPaintingPermaculturePlumbingReal EstateRestorationRoofingSheet MetalSafety/OSHASolarTile
Can you commit to approximately 30 hours of live in-person training? *
Training is 2 hours per class on Tuesdays and Thursdays from 12:30pm - 2:30pm
Can you commit to 10-12 hours of self-guided safety training and testing?*
The self-guided training/testing is an online class for CalOSHA safety certifications
Do you have a camera-enabled computer or tablet?*
The NextGen Trades Academy has laptops that can be checked out for the program
Do you have reliable internet connection?*
The NextGen Trades Academy can help with a hotspot for the program
Do you have any activities that can interfere with attendance in the program?*

YesNoI'm Unsure
If you answered yes to the question below, please list which activities may interfere
Examples may include work, sports, band, dance, school clubs, babysitting, etc.
Please select which services can support your success (check all that apply)*

Educational CounselingAlternative School ServicesAdult Education and Literacy ActivitiesNeeds Work ExperienceChild Care AssistanceFamily CounselingMental Health CounselingOccupational Skills TrainingJob Readiness TrainingOn the Job TrainingSkill Upgrade/RetrainingSummer Employment OpportunitiesInternshipAdult MentoringLeadership DevelopmentEntrepreneurial TrainingAlcohol & Drug Counseling
Which of the following categories may impact your success (check all that apply)*

Learning DisabilityHomelessRunawayVictim of domestic violencePregnantParenting TeenPoor Work HistoryFoster YouthGang AffiliationTransportation issuesAt risk of dropping out of schoolDifficulty completing an educational programDifficulty obtaining employmentOne or more parents are incarceratedPrefer Not to Answer
General Contact Information
Legal Name*

First NameLast Name
Preferred Name or Nickname

First NameLast Name
Phone Number*
Please enter a valid phone number.
E-mail*
Please use a personal email instead of a school or college email. example@example.com
If you are a minor, under 18 years, please provide your parent or guardian name
Parent/Guardian Phone Number
Please enter a valid phone number.
Parent/Guardian Email
example@example.com
Present Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What county do you live in?*
List your mailing address if it is different than the address listed above
When is the best time to contact you?*
List days and/or times
What is the best method to contact you? Check all that apply*

TextCallEmail
Name of Emergency Contact*
Relationship*
ex. Father, Mother, Guardian, etc.
Emergency Contact Phone Number*
Please enter a valid phone number.
Emergency Contact Email *
example@example.com
Demographic and Other Information

This information has no influence on your acceptance to the program. Please answer as much as you feel comfortable as it helps us with reporting program impact to our funders.
Birth Date*

MonthDayYear
Date
Age*
Grade (if still in high school)
Gender*

MaleNon-binaryFemalePrefer not to answer
Marital Status*

SingleCohabitatingMarriedSeparatedDivorced
Race/Ethnicity*

African American / BlackAsianCaucasian / WhiteHawaiian Native / Pacific IslanderHispanic / LatinoNative American / Alaskan NativeMultiracialNot Stated (or Decline to State)Other
Number of people in household*

1-23-45-67 or more
Total annual/yearly household income (required)*
Do you receive supplemental forms of support? (Ex. Food Assistance, Disability)*

YesNoI'm Unsure
Do you rent or own your home?*

RentOwnI'm unsure
Do you have veteran status?*

Yes, I am a veteranNo, but I'm thinking of joining the militaryNoOther
Have you dropped out of school?*

YesNoNot yet, but I'm considering it
Name of school last attended or currently attending*
Have you received your high school diploma or GED?*

Yes, I have a high school diplomaYes, I have a GEDNot yet, but on-track for my high school diplomaNot yet, but on-track for my GEDNo
Do you have valid identification? (Ex. CA identification, driver's license, passport)*

YesNoI'm Unsure
Do you have a valid driver's license?*

YesNot yet, but I'm working on itNo
Are you a parent?*

YesNoOther
Has applicant been convicted of a misdemeanor?*

YesNo
Has applicant been convicted of a felony?*

YesNo
Are you legally eligible to work in the United States?*

YesNoI'm unsure
Do you require any adaptive equipment to assist with employment or training?*

YesNo
Do you have work history?*

YesNo
If you have work history, please share more information about your experience.
Company Name
Acknowledgement Section

The following 5 acknowledgements are required for program participation: (1) Release of Confidential Information, (2) Equal Opportunity Statement, (3) Grievance Policy, (4) Media Release, (5) Attestation
I. ACKNOWLEDGEMENT OF UNDERSTANDING AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INFORMATION

In compliance with the Family Educational Rights and Privacy Act (FERPA), The LIME Foundation's NextGen Trades Academy is responsible for the security and maintenance of customer records and educational records and for monitoring release of information related to those records. LIME programs and those operated by partner agencies and organizations listed below are responsible for the direct and indirect provision of services as set for in NextGen Trades Academy. Staff from some or all of the agencies may need to access Applicant records and student records to ensure the highest quality delivery o services to the individual applicant. The agencies that may be involved in the delivery of services to you, the participant, are:

The LIME Foundation
School officials
GED/ABE Literacy Programs HUD Department of Human Services Welfare-to-Work Unemployment Insurance
Child Support Enforcement Child Welfare
Job Corps
Police Departments
Selective Service officials Veterans Administration Official
Native American Program Grantee(s) Department of Vocational Rehabilitative Services Court officials
Employers (past, present, future)
Juvenile Services
Youth and Family Services of Sonoma County Social Security officials
Alcohol/Drug Rehabilitation Agency officials Shelter officials
Medical professionals
Vocational Technical school
YWCA Domestic Violence Center
Others as deemed appropriate for each Applicants needs

I agree that the LIME NextGen Trades Academy may release any information furnished by me and requested by prospective employers, educational institutions or social service agencies.

I also agree that the LIME NextGen Trades Academy staff may obtain confidential information regarding services provided to me by other educational institutions or social service agencies.

I further authorize the release of employment and income information by any employer to the LIME NextGen Trades Academy.

I understand services I may be provided are dependent upon continued funding and in the instance the LIME NextGen Trades Academy should fail to receive funding for NextGen Trades Academy, all services and agreements will be null and void.

I understand that this authorization will be continuing until it is revoked in writing and such revocation is delivered to the LIME NextGen Trades Academy office. I have read and understood the above information and will, under penalty of law, comply with all rules, regulations.

*If you are under 18, your parent or guardian will also need to sign their acknowledgement at the end of this agreement*
II. EQUAL OPPORTUNITY STATEMENT: EQUAL OPPORTUNITY IS THE LAW

26 CFR Sec. 37-30
It is against the law for a recipient of federal financial assistance to discriminate on the following basis:
-Against any individual in the United States, on the basis of race, color, religion, sex, national origin, age, disability, political
affiliation or belief and;
-Against any beneficiary of programs financially assisted under Title I of the Workforce Investment Act of 1998 (WIA), on the basis of the beneficiary's Citizenship/status as a lawfully admitted immigrant authorized to work in the United States, or his or her participation in any WIA Title I-financially assisted program or activity.

The recipient must not discriminate in any of the following areas:
- Deciding who will be admitted, or have access, to any WIA Title I-financially assisted program or activity;
- Providing opportunities in, or treating any person with regard to, such a program or activity; or
- Making employment decisions in the administration of, or in connection with, such a program or activity.

WHAT TO DO IF YOU BELIEVE YOU HAVE EXPERIENCED DISCRIMINATION
If you think that you have been subjected to discrimination under a WIA Title I financially assisted program or activity, you may file a complaint within 180 days from the date of the alleged violation with either:

- The recipient's Equal Opportunity Officer (or the person whom the recipient has designated for this purpose); or
- The Director, Civil Rights Center (CRC), U.S. Department of Labor, 200 Constitution Avenue NW, Room N-4123, Washington, DC 20210.

If you file your complaint with the recipient, you must wait either until the recipient issues a written notice of Final Action, or until 90 days have passed (whichever is sooner), before filing with the Civil Rights Center (CRC), U.S. Department of Labor, 200 Constitution Avenue NW, Room N-4123, Washington, DC 20210.

If the recipient does not give you a written Notice of Final Action within 90 days of the day on which you filed your complaint, you do not have to wait for the recipient to issue that Notice before filing a complaint with CRC. However, you must file your CRC Complaint within 30 days of the 90-day deadline (in other words, within 120 days after the day on which you filed your complaint with the recipient.)

If the recipient does give you a written Notice of Final Action in your complaint, but you are dissatisfied with the decision or resolution, you may file a complaint with CRC. You must file your CRC complaint within 30 days of the date on which you received the Notice of Final Action.

Assurance Statement

As a condition to the award of financial assistance from the Department Labor, under Title I of WIA, the grant applicant assures that it will comply fully with the nondiscrimination and equal opportunity provisions of the following laws:
- Title VI of the Civil Rights Act of 1964
- Section 504 of the Rehabilitation Act of 1973

- The Age Discrimination Act of 1975
- Title IX of the Education Amendments of 1972

*If you are under 18, your parent or guardian will also need to sign their acknowledgement at the end of this agreement*
III. GRIEVANCE POLICY

What is a Participant Grievance? An expression of dissatisfaction relating to any service provided by The LIME Foundation, to include violation of civil rights, type of service or other conditions.

It is the policy of the agency to ensure that Participants receive fair and equitable treatment through provision of an easily accessible procedure for expression and reconciling grievances and that Participants feel free to use the procedure without fear of criticism or action being taken against them. The LIME Foundation will not discriminate against persons regardless of race, color, religion, sex national origin, or political affiliation in the process of recruiting, appointing, promoting, demoting, evaluating, compensating, or removing Participants.

This policy has application to all services provided by The LIME Foundation. All time limits listed are business days.

Grievance hearings are to be scheduled at mutually convenient times.

New grievance issues not raised by Step I may not be raided by either party at Step II. All persons involved must treat all grievances with the utmost confidentiality.

A written summary of the complaint and facts and information accumulated should be made by the staff person and the Executive Director at each step and forwarded to the Board of Directors, with copies of grievance appeals and responses.

Procedures
A. Informal Grievance-Every reasonable effort should be made by the staff person and Participant to resolve any questions, problems and misunderstandings that may arise. Accordingly, staff persons should immediately discuss any complaints or questions they may have with their immediate supervisor and are urged to initiate such discussions at the time the Participant expresses dissatisfaction or questions arise.

The Executive Director and Supervisors, in turn, should take positive and prompt action to answer Participant’s question and resolve complaints presented.

These informal grievances must be in writing.

The applicant or the representative of the applicant shall have access to records relevant to the appeal process.

B. Step I-Formal Grievance-If a Participants’ problem has not been resolved after discussing the concern with the staff person, a grievance may be initiated with the Executive Director at Step I. These grievances must be in writing. To be accepted for consideration, a grievance must be initiated within ten (10) days following the date when the incident arose. The Executive Director arranges a meeting with the Participant and the staff person to discuss the complaint develops all the available facts and information relevant to the grievance and issues a decision within ten (10) days after receiving grievance. In cases where oral responses have been given the Participant, a memorandum summarizing the response should be prepared and forwarded to the aggrieved party.

C. Step II-Appeals-If satisfactory resolution of the grievance is not reached at Step I, the Participant may request that the grievance be appealed to the Board of Directors within seven (7) days after receiving the Step I decision; the grievance is considered settled on the basis of the Step I decision if such request is not presented. Upon receiving the grievance, in writing, the Board of Directors shall meet with the client at the next regularly scheduled board meeting after received the grievance to hear the client’s viewpoint. The Board of Directors written decision is presented to the aggrieved employee within five (5) days following the meeting, with copies tothe Executive Director. This appear, when presented to the Board of Directors, will be the final authority.

Board of Directors

With respect to the grievance appeals, a quorum of Board of Directors shall suffice. The Executive Director and other ex-officio members of the Board of Directors shall vacate their seats during discussion of the grievance matters.

Representation

Only the client, their personal representative, and person designated by the Board may attend the Grievance Hearings.

If any client fails to follow the grievance procedure, he or she will be directed by the Executive Director and/or Board of Directors to review the grievance procedure and to follow the procedure as written.

You will be provided a copy of this document for reference should the need arise. A second copy will be placed in your participant file folder.

This is to certify that I have read and understand my rights regarding grievances.
IV. MEDIA RELEASE

I, [applicant, or guardian of a minor applicant] grant The LIME Foundation my permission to use video or photographs of applicant at The LIME Foundation events and NextGen Trades Academy classes for any legal use, including but not limited to: publicity, copyright purposes, illustration, advertising, and web content.

Furthermore, I understand that no royalty, fee or other compensation shall become payable to the applicant [or guardian of a minor] by reason of such use.

If you do not wish to sign this release, please write "OPT OUT" in both boxes below. If you do wish to sign the release, please sign (or if under 18, please have your guardian sign at the end of the agreement).
If you do not want your media released, type "OPT OUT" below
V. COVID POLICY AND SAFETY PROTOCOLS

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.

The NextGen Trades Academy (NGTA) has put in place preventative measures to reduce the spread of COVID-19. The safety protocols are in compliance with CDC recommendations, including wearing masks, social distancing, limitations on group size, and regular sanitation practices. However, NGTA cannot guarantee that students will not become infected with COVID-19. Further, attending in-person field trips could increase student risk of contracting COVID-19.

By participating in field trips, students and parents acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that participants may be exposed to or infected by COVID-19 by attending the NGTA program. Such exposure or infection may result in personal injury, illness, permanent disability, and death. All participants understand that the risk of becoming exposed to or infected by COVID-19 during NGTA field trips may result from the actions, omissions, or negligence of participants and others, including, but not limited to, NGTA employees, volunteers, and program participants and their families.

All participants voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any exposure or infection by Covid-19. Students and parents will hereby release, covenant not to sue, discharge, and hold harmless NGTA , its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. Participants understand and agree that this release includes any Claims based on the actions, omissions, or negligence of NGTA , its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any NGTA program.

Students and parents agree not to attend NGTA field trips if they are experiencing symptoms of COVID-19 such as cough, shortness of breath, or fever, have a confirmed or suspected case of COVID-19, or have come in contact in the last 14 days with a person who has been confirmed or suspected of having COVID-19. NGTA will pre-screen students prior to the field trip. If a student is experiencing symptoms that may be COVID related, that student will not be permitted to participate in further in-person field trips until a negative COVID test is provided.

*If you are under 18, your parent or guardian will also need to sign their acknowledgement at the end of this agreement*
VI. DIVERSITY, EQUITY, INCLUSION (DEI)

The LIME Foundation (LIME) is dedicated to providing equity for all members, program educators, students and staff of the Foundation. LIME is committed to diversity where people of all genders, gender identification, age, religion, culture,
race and socioeconomic levels are invited and included to be a part of the LIME Foundation’s programs, activities and governance. Inclusion is evident in the active invitation and engagement of contribution and participation of diverse
people.

The LIME Foundation provides a level playing field for a diverse body of students, instructors and educators, where all are encouraged to participate and engage peacefully.

DEI Defined

Diversity is the full range of ways a person can identify. Diversity in the workplace is the concept of and practice in having our organization reflect the communities we serve. Diversity has many facets including race, ethnicity, gender or
gender identity, age, religious affiliation, and sexual orientation. Diversity also includes people with differing educational backgrounds, personality types, cultural references, experiences, or physical abilities.

Inclusion is when every single person in the community is valued, heard, respected, empowered, and feels a true sense of belonging in our organization. It goes beyond tolerance to actually celebrating and elevating every person in the
room; it is the practice of inviting, requesting and engaging our diverse foundation into participating in our programs and initiatives.

The LIME Foundation believes:
- A diverse student body and workforce drive economic growth.
- Recruiting from a diverse pool of candidates means a more qualified workforce.
- Diversity fosters a more creative, collaborative and innovative workforce.
- Diversity is a key aspect of entrepreneurialism with strong entrepreneurs.
- Diversity in business ownership, particularly among BIPOC, is key to moving our economy forward.
- Diversity in the workplace is necessary to create a competitive economy in a globalized world.
- Diversity in the boardroom and among the Board is needed to enhance and leverage the LIME Foundation’s full
  pote.
VII. AGREEMENT

I have read and understand each application item thus far and certify that the information is true and accurate to the best of my knowledge. I further realize that falsified information may result in the rejection of this application and subsequent termination from services.

I understand someone will contact me within 72 business hours about my application.
By signing below, the applicant attests to the responses within the application

Clear
Date Signed*

MonthDayYear
Date
Signature of Parent/Guardian to attest to the responses within the application

Clear
Name of Parent/Guardian Signing

First NameLast Name
Please verify that you are human
Should be Empty:

Academy Application

General Interest Questions

Eligibility

General Contact Information

Demographic and Other Information

Acknowledgement Section