Youth Application: Training Academy
Name
*
First Name
Last Name
Date of Birth
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-
Month
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Day
Year
Date
Email
example@example.com
Phone Number
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City/Town and State
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Street Address
Street Address Line 2
City
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Alabama
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District of Columbia
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Pennsylvania
Rhode Island
South Carolina
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Tennessee
Texas
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Washington
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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
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?
Job and Career Exploration: Feb 4 – Mar 4, 2026, Wednesdays 5:00 - 6:00 PM
Self-Advocacy: Feb 4 – Mar 25, 2026, Wednesdays 6:30 - 7:30 PM
Summer (Self-Advocacy & Workplace Readiness): Jul 13-17, 2026, M–Fri 12-3PM
Workplace Readiness: Oct 7 – Nov 25, 2026, Wednesdays 6:30 – 7:30 PM
Post-Secondary Exploration: Oct 21 – Nov 4, 2026, Wednesdays 5:00–6:00 PM
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
Why are you interested in joining the Training Academy?
What additional information you want us to know about you?
Do you have reliable transportation to get to Austin17House?
Please Select
Yes
No
Sometimes. I might need help
If you don't have reliable transportation, we might be able to help. Please let us know.
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
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