Please be advised that completing this application does not guarantee employment with the program. Space is limited. Applicants selected for an employment interview will be notified by mail. Applicants must qualify based on income standards.
Please have a parent or guardian complete the section below. If you are 18 years of age or older and live independently, please complete this section yourself. Please check all sections of benefits listed below that the youth listed on this application is currently receiving. All areas checked will be verified with the Chemung County Department of Social Services to determine program eligibility.