Youth Services Network Partnership Application

Youth Services Network Partnership Application

Thank you for your interest in becoming a partner with the City of Antioch’s Youth Services Network. This application is designed for organizations interested in providing meaningful, safe, and developmentally appropriate workforce experiences for Antioch youth and young adults. Through the Youth Services Network, approved partner organizations may have the opportunity to host City-funded interns who are seeking to gain valuable hands-on experience, develop professional skills, and explore career pathways. Placement opportunities are based on program availability, organizational needs, and the suitability of the work experience for participating youth.
Directions: Please complete the application below. City staff will review your submission and contact the email address provided with additional information regarding partnership requirements, next steps, and potential internship placement opportunities. For inquiries, please contact youth@antiochca.gov
Organization/Business Name:
Site Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this site accessible through public transportation?
Please indicate the type of Business you are.
Primary Contact Name:

First NameLast Name
Contact Email: (This will be used for coordination and program communication.)
example@example.com
Contact Phone:
Please enter a valid phone number.Format: (000) 000-0000.
Field Of Work

Other
What are examples of tasks your participants will be expected to perform?
Will interns work with vulnerable populations (youth, seniors, unhoused, disabled persons, justice-involved persons, or survivors of domestic violence)?
Will your participants be engaging in strenuous physical activity? If so, please explain.
Are there any physical requirements (lifting, prolonged standing, outdoor work, etc.)? If so, please explain.
Can reasonable accommodations be provided for participants as needed?
Will the youth participants be required to provide their own laptop or device?
What day(s) would you prefer interns to work?
Preferred start date:
Preferred end date:
What are the maximum hours you would like interns to work per day?
What is the maximum number of hours you would like for interns to work per week (approximately)?
Select the minimum number of interns your organization is able to accept for a 4-6 month period.
Select the maximum number of interns your organization is able to accept for a 4-6 month period
Is the schedule flexible for school and program requirements?
Are there any forms that interns or parental guardians will need to sign? If yes please list the required documents below.
Please list any preferred skills for interns at your worksite

Other
Should be Empty: