Youth Employment Program (YEP) Application

The Georgetown Project Youth Employment Program (YEP) Internship Application

Fill the form below accurately.
GENERAL INFORMATION
Legal Name*

First NameLast Name
Preferred Name
Race*
Sex*
Sex at Birth
Gender
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you reside within the Georgetown Independent School District zoning?*

YesNoUnsure
Phone Number*
Is the number you provided your cell number*

YesNo
If yes, may we contact you via text messages?*

YesNo
Email*
example@example.com
What size t-shirt do you wear?*
Birth Date*

MonthDayYear
Will you have reliable transportation?*

YesNoUnsure
Do you currently have a valid Driver's License or a Government issued ID?*

YesNo
Parent/Guardian Name (required if under 18)

First NameLast Name
Parent/Guardian Email
example@example.com
Phone Number
Please enter a valid phone number.
Emergency Contact*

First NameLast Name
Your Relationship With Your Emergency Contact*
Phone Number*
Please enter a valid phone number.
Please be advised

If selected, you must complete an IRS W9 form with a valid Social Security number and identity verification (school ID, driver's license, etc.) Taxable stipend income is reported to the IRS.

REFERENCES
REFERENCES

Please list two (2) references who are NOT related to you and know your work. You may use a teacher as a reference. Your reference needs to be someone over 18 years old.
Reference*
Reference*

INTERNSHIP INTERESTS
INTERNSHIP PLACEMENT INTERESTS

Spaces are limited. No guarantees can be made about placements--sites can vary.

Please rate based on your preferences

Other Interests (Please Describe)
What experiences have you had that would prepare you for your first job (or this opportunity)?
Please explain your reason(s) for applying for the YEP internship:
What would you like to learn or what skills would you like to develop?

PERSONAL INFORMATION
Medical Condition(s) and/or Accommodation(s) that The Georgetown Project/Worksite supervisor needs to be aware of:
Have you ever been convicted of a crime?*

YesNo
If yes, please explain:
Do you agree to complete a background check?*

YesNo
Are you under 18 years-old?*

YesNo
If you are under 18, please provide your parent/guardian's email address
example@example.com

APPLICATION SUBMISSION
Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Date
For more information, please get in touch with the Youth Employment Program Coordinator at syep@georgetownproject.org

The Georgetown Project- syep@georgetownproject.org - 512.943.0074 - www.georgetownproject.org
Should be Empty:

The Georgetown Project Youth Employment Program (YEP) Internship Application