2025 Culinary Youth Training Program Participation Application

LA Cocina de Gloria Molina Culinary Youth Training Program provides young people from under-resourced communities with job-ready skills to enter the restaurant and hospitality industry. The bilingual curriculum offers hands-on cooking classes introducing students to the basics of kitchen safety and recipe execution. Students complete the course with a working resume and an oppertunity to take the California ServSafe exam to better prepare for the workforce.

This program is free of charge and includes the ServSafe test and printed course materials. A transportation stipend is also available. Students are invited to participate in networking events with chefs, restauranteurs, and culinary schools. Professional development resources are also provided.

Please fill out the information alongside a parent and/or guardian. If you should have any questions, please contact LA Cocina de Gloria Molina by emailing cocina@lapca.org or by calling (323) 397-8365.

The Culinary Youth Training Program is made possible by the SNAP Foundation and the PepsiCo Foundation.
Section 1: General Information

Please fill in the applicant's information with as much accuracy as possible.
Take Photo. This allows us to develop a student profile for each applicant. *
Legal Name *

First NameLast Name
Preferred Name (Please adjust if different from Legal Name; We will use this name to develop name tags for accepted participants *

First NameLast Name
Pronouns (she/her/he/his/they/them)*
Date of Birth*

MonthDayYear
Date
Age*
Mailing Address (Please make sure that it is a FULL AND COMPLETE ADDRESS that can be used to mail information to you.) *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email (Please make sure that the email address listed can be used to contact you directly). *
example@example.com
Cell Phone Number *
Please enter a valid phone number.
Home Phone Number
Please enter a valid phone number.
Race/Ethnicity (optional)
Accessibility Requests
Section 2: Emergency Contact Information

First Point of Contact in the Case of Emergencies. Please fill in the information below.
Parent/Guardian Full Name*

First NameLast Name
Home Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Cell Phone Number*
Please enter a valid phone number.
Work Address (if applicable; if parent/guardian is working from home, please provide address of residence.) *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Section 3: Emergency Contact Information

Second Point of Contact in Case of Emergencies. If applicable, please fill in the information below.
Parent/Guardian Full Name

First NameLast Name
Home Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Work Address (if applicable; if parent/guardian is working from home, please provide address of residence.)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Section 4: Additional Admissions Information
Are you currently in high school, college/university, or attending another educational institute?*

YesNo
If "Yes," please select your current education level*

High SchoolCommunity CollegeUniversity (Bachelor's Degree)Graduate SchoolOther
Please name below the educational institution you are currently attending
Example: California State University, Los Angeles
If "No," are you currently employed?

YesNo
How did you find out about LA Cocina de Gloria Molina Culinary Youth Training Program?*

Career CenterReferral from Family, Teacher, or FriendLA Plaza Social Media PromotionOther
If "Other," please share how you found out about us.
Are you currently ServSafe Certified or have an unexpired Food Handler's Certificate?*

YesNo
Are you able to attend the first day of class? If not, please note that we will NOT be able to retain your seat for this program. This will result in your immediate removal from the program and the seat will be given to another student.*

YesNo
LA Cocina de Gloria Molina is a bilingual serving community program. Will you need the instructors to speak in Spanish to assist you with the materials taught in the program?*

Yes/SiNo
Do you have a food allergy or dietary restriction?*

YesNo
If "Yes," please share with us your food allergy and/or dietary restrictions below. (Please note that this information will be shared with the Chef Instructors.)
Do you have any medical conditions or physical limitations that might interfere with your ability to participate in the program?

YesNo
If "Yes," please list below your Medical Conditions and/or your Physical Limitations
In 250 words, please share why you'd be interested in joining LA Cocina de Gloria Molina's Culinary Youth Training Program, and how it would help you advance in your career plans. *
If you are admitted into LA Cocina de Gloria Molina Culinary Youth Training Program, we provide for each student either a free parking pass to our parking lot or a MetroTAP Card for public transportation. Please select your needs regarding your mode of transportation. Once you've made your decision, you will be unable to make any changes.*

Parking PassMetroTAP Card
Section 5: Cohort Selection

LA Cocina de Gloria Molina Culinary Youth Training Program holds various cohorts throughout the year. To ensure student availability, and a full class, please see the information below on how best to select your cohort of choice.
For 2025, the Culinary Youth Training Program will host 8 cohorts for students to enroll in the program, with each having a varied start and end date.

Please review the dates carefully on our website in the chart provided below, as we will be taking your application into consideration depending on the dates you select to join our program.

Winter 2025

Program Class Time (Tues. & Wed. 5-7pm)

February 4 - March 5

Spring (I) 2025

Program Class Time (Tues. & Wed. 5-7pm)

March 18 - April 16

Spring (II) 2025

Program Class Time (Tues. & Wed. 5-7pm)

April 29 - May 28

Summer (I) 2025

Program Class Time (Tues. & Wed. 5-7pm)

June 10 - July 9

Summer (II) 2025

Program Class Time (Tues. & Wed. 11am-1pm)

July 15 - August 8

*Please note that this cohort is 4 weeks long, and the last week requires that students be in class from August 5-8th*

Fall (I) 2025

Program Class Time (Tues. & Wed. 5-7pm)

August 19 - Sept 17

Fall (II) 2025- Baking-Only Cohort

Program Class Time (Tues. & Wed. 5-7pm)

Sept 30 - Oct 29

*Please note that this cohort is a Baking Only Cohort

Winter (II) 2025

Program Class Time (Tues. & Wed. 5-7pm)

November 4 - Dec. 10

Once you have taken a moment to review the charts with the dates for each cohort, please note of the following: Your first selection will be taken into priority and the secondary choice will be taken into consideration in the case your first choice has filled. You will be contacted as this occurs.

Please select only TWO options for when you'd like to join the 2025 LA Cocina de Gloria Molina Culinary Youth Training Program
Select Cohort - Primary Choice:*
Select Cohort (Primary Choice)*
Select Cohort (Secondary Choice)
Please note that this will be taken into consideration only if the above spaces become available. You will be contacted regarding which cohort you've been officially placed in.
Section 6: Waivers and Codes of Conduct

Please read the information below carefully alongside a parent/guardian.
Culinary Youth Training Program Participants Code of Conduct
- I will treat participants and staff with respect and common coutesy.
- I will listen respectfully to instructors and staff members.
- If I have a complaint or concern about anything or anyone, I will contact a staff member (in private if necessary) rather than be degoratory or negative in public.
- I will refrain from any physical violence of any kind, or the threat of physical violence towards a fellow participant, the public, or representatives of LA Plaza de Cultura y Artes and LA Cocina de Gloria Molina.
- I will refrain from objectionable demonstrations such as throwing items or any other forceful actions towards fellow participants or representatives of LA Plaza de Cultura y Artes and LA Cocina de Gloria Molina.
- I will always stay within the specified LA Cocina de Gloria Molina facility limits unless a LA Plaza representative instructs me otherwise.
- I will treat the LA Cocina de Gloria Molina facility, supplies and equipment respectfully.
- I will help keep the LA Cocina de Gloria Molina facility clean by picking up after myself and others.
I agree that if I do not comply with these rules or engage in any other detrimental behavior, at any time throughout the time of the Culinary Youth Training Program, LA Plaza de Cultura y Artes and LA Cocina de Gloria Molina reserves the right to the following behavior mamagement plan, and will document unwanted behavior in a participant's folder: 1st indecent will result in a verbal warning; 2nd indecent will result in being asked to sit out activity; 3rd indecent will result in removal from activity and conference with student, chef instructors, and parent/guardian. Serious or continuing problems may result in immediate removal from the Culinary Youth Training Program
Participant's Signature *

Clear
Date Signed *

MonthDayYear
Date
Privacy and Confidentiality Policy

Information of applicants to LA Cocina de Gloria Molina Culinary Youth Training Program will be used for the following purposes:
- Funding and Grant Application Needs: For applications pertaining to and for the purpose of funding the Culinary Youth Training Program.
- Chef Instructor Informaiton: To provide Chef Instructors' information on incoming students.
- Information Distribution: This includes communications via email, phone call, and mailing address for sending information about the program and future events.
A copy of your application will be provided to all applicants via email or in printed format. Information from applications to LA Cocina de Gloria Molina Culinary Youth Training Program such as names, birthdates, medical and food allergy informaiton will be confidential and will not be disclosed or distributed to third parties outside the organization of LA Plaza de Cultura y Artes.

The materials used and distributed at LA Cocina de Gloria Molina Culinary Youth Training Program are confidential and cannot be copied or redistributed as LA Plaza de Cultura y Artes are the sole owners of the materials used throughout the program.

I agree and have read the Privacy and Confidentiality Policies listed above.
Participant's Signature*

Clear
Parent/Guardian Signature *

Clear
Date of Signatures *

MonthDayYear
Date
Culinary Youth Training Program Photo/Video Release

I hereby give permission for images of myself, captured during regular and special Culinary Youth Training Program activities through video, photo and digital camera (including but not limited to theuse of camera devices and the mobile phone devices) to be used solely for the purpose of of promotional material and publications, and waive any and all rights of compensation or ownership thereto.
Participant Signature *

Clear
Parent/Guardian Signature *

Clear
Date of Signatures*

MonthDayYear
Date
LA Cocina de Gloria Molina Culinary Youth Training Program Liability Waiver

I fully understand that the participation of myself or my child in LA Cocina de Gloria Molina's Culinary Youth Training Program and related activities within the program (herein "program") exposes them to risks of personal injury, death and property damage. Personal injury includes cuts (lacerations), burns, bruises, falls, bacterial contamination, sprains and other forms of bodily injury, I hereby acknowledge that I am granting myself or my child/children permission to participate in the program and agree to assume such risks.

In consideration for being permitted to participate in the program, I hereby agree for myself, my heirs, administrators, executors, and assigns to indemnify and hold harmless LA Plaza de Cultura y Artes and LA Cocina de Gloria Molina, its employers, or agensts from any and all claims, demands, actions or suits arising ou of or in connection with myself or my child's participation in the program from whatever the cause including the active or passive negligence of LA Plaza de Cultura y Artes or any other participant in the Culinary Youth Training Program.

I hereby represent that I (the program participant) or my child hsa no physical impairment that would limit the ability to participate in the activities planned.

I have read the Code of Conduct and agree to instruct myself or my child to cooperate to the fullest to the staff of the program(s) of the LA Plaza de Cultura y Artes (which includes LA Cocina de Gloria Molina) Culinary Youth Training Program.

This release and consent shall remain in effect until the end of the program.

I HAVE READ CAREFULLY THIS RELEASE AND HOLD HARMLESS AND AGREEMENT TO NOT SUE AND FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT IT IS A FULL RELEASE OF ANY AND ALL LIABILITY WITH THE CITY OF LOS ANGELES , LA PLAZA DE CULTURA Y ARTES, AND LA COCINA DE GLORIA MOLINA AND SIGN OF MY OWN FREE WILL.
Participant Signature *

Clear
Parent/ Guardian Signature *

Clear
Date of Signatures*

MonthDayYear
Date
Should be Empty:

Section 1: General Information

Section 2: Emergency Contact Information

Section 3: Emergency Contact Information

Section 4: Additional Admissions Information

Section 5: Cohort Selection

Section 6: Waivers and Codes of Conduct