Mile High Youth Corps : Youth Jobs : Youth Jobs Application Form

Application For Employment

As an Equal Opportunity Employer, Mile High Youth Corps considers all applicants for employment without regard to race, color, religion, sex, marital status, sexual orientation, national origin, ancestry, age, handicap. Decisions to hire are based solely upon a qualified applicant's ability to perform a job and upon dependability when hired. Mile High Youth Corps also provides "reasonable accommodations" to qualified persons with disabilities, in accordance with the Americans with Disabilities Act and applicable state and local laws. Any applicant requiring reasonable accommodation to the application and/or interview process should notify a representative of Mile High Youth Corps.

Program Applying For:

	Summer of Service
	AmeriCorps 900 hr
	Water Conservation Program
	YouthBuild

Date You Will Be Available to Start Work:

Each question must be answered fully and accurately.

General Information

Name:

SS#:

Email Address::

Mailing Address:

(P.O. Box or number and street)

City, State, ZIP:

Phone Number:

(include area code)

Date of Birth (including year):

Alternate Phone/Pager:

(include area code)

How did you hear about Mile High Youth Corps:

Have you ever worked here before:

	Yes
	No

If yes, when:

Have you ever applied here before:

	Yes
	No

If yes, when:

Immigration statement: Federal laws require that employers hire only individuals who are authorized to be lawfully employed in the US. In compliance with such laws, MHYC will verify the statues of every individual offered employment with the company. All offers of employment are subject to verification of the applicant’s identity and employment authorization, and it will be necessary for you to submit such documents upon employment.

Can you submit proof of your work eligibility:

	Yes
	No

Employment History

Please list your last 2 employers, full-time or part-time.

Company Name #1:

Address:

City, State, ZIP:

Phone Number:

Job Title/Position:

Wage/Salary:

Dates of Employment:

Responsibilities/Duties:

Reason for Leaving:

Company Name #2:

Address:

City, State, ZIP:

Phone Number:

Job Title/Position:

Wage/Salary:

Dates of Employment:

Responsibilities/Duties:

Reason for Leaving:

Please explain any period of unemployment:

Description:

References

Please provide us with the names and phone numbers of three references (not relatives) whom we can contact.

Reference #1 Name:

Phone Number:

Occupation:

Relationship to Applicant:

Reference #2 Name:

Phone Number:

Occupation:

Relationship to Applicant:

Reference #3 Name:

Phone Number:

Occupation:

Relationship to Applicant:

General

Have you, in the last 7 years, been convicted of a crime:

(a conviction will not automatically be a bar to employment. This information will be used only for job-related purposes and only to the extent permitted by applicable laws)

	Yes
	No

Is there anything that would prevent you from performing the essential job functions in a reasonable and safe manner for the position for which you have applied:

(Do not respond if you have not seen the job description for this position)

	Yes
	No

If yes, please explain the things you cannot do and describe how Mile High Youth Corps could help you accomplish the essential job functions for the position:

Have you ever received an AmeriCorps Education Award or been enrolled in an AmeriCorps program before:

	Yes
	No

If so, where:

Education And Training

Are you still in High School:

	Yes
	No

Please describe your educational background using the fields below

High School Name:

Address:

City, State, ZIP:

Course of Study:

(if any)

Dates Attended:

Diploma or Degree Received:

(if any)

College/Vocational School Name:

Address:

City, State, ZIP:

Course of Study:

(if any)

Dates Attended:

Diploma or Degree Received:

(if any)

Skills / Experience

Please describe other volunteer or community service experiences you have had in the past:

If you have any other skills, licenses, certificates and/ or other qualifications you wish to mention, please list:

Short Answer Questions

Please tell us why you want to become a member of Mile High Youth Corps:

A major part of the Mile High Youth Corps program involves learning about the environment and the community. What would you like to learn and why:

What are your future career and education goals:

Read Before Submitting

I affirm that all of the information provided in this application is true and accurate. I understand that the falsification of any information may be cause for immediate termination from the Mile High Youth Corps in the event that I am hired.:

Yes

If I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to admit such proof within the required time will result in termination of my employment.:

Yes

In processing my application for employment, I authorize Mile High Youth Corps and/or its agents to verify all answers, statements and information provided by me. I hereby release Mile High Youth Corps from any and all liability for any damage whatsoever arising from investigating and verifying the referenced information.:

Yes

If applicant is under the age of 18, please have parent or guardian complete the fields below:

Parent or Guardian's Name:

I hereby give permission for the above named applicant to participate in the Mile High Youth Corps program.:

Yes

Mile High Youth Corps places a priority on serving youth from the following Denver neighborhoods. If you live in one of these neighborhoods, designate the neighborhood name.:

Colored fields indicate required information.