Youth Application: Training Academy
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
City/Town and State
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
What's your highest level of education?
Please Select
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Some College or Trade School
Has anyone in your immediate family attended college?
Yes
No
Back
Next
Save
How did you learn about the Training Academy at the Austin17House?
Please Select
Austin17House
Social Media
School
Family
Friends
Other
Which program would you like to join at the Austin17House Training Academy?
Please Select
Workforce Basics
What do you need help with most as you think about entering the workplace? (select all that apply)
Understanding what employers expect and how to keep a job
Building confidence in myself
Learning how to show up on time and follow a work schedule
Filling out job applications or creating a resume
Preparing for interviews and knowing what to say
Communicating clearly and professionally with coworkers or supervisors
Learning how to manage my money once I start earning
Figuring out what kind of job or career might be a good fit for me
Other
Why are you interested in joining the Training Academy?
What additional information you want us to know about you?
Back
Next
Save
Are you available to attend weekly sessions from September through November, including two-three evenings per week and one Saturday for the final showcase?
Please Select
Yes
No
Not sure yet
Do you have reliable transportation to get to Austin17House?
Please Select
Yes
No
Sometimes. I might need help
Do you have any language preferences, learning needs, or accessibility concerns you’d like us to know about?
Emergency Contact Name
*
Emergency Contact Relationship
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Have you completed the Austin17House Youth Participant Form?
*
Yes
No, and I will do that on the next page
Save
Submit
Should be Empty: