Work Experience Application Youth Work Experience Application CareerSource Southwest Florida Youth Employment Application Please register on www.employflorida.com for future correspondence with CareerSource Southwest Florida and to determine eligibility for the Workforce Innovation Opportunity Act (WIOA). To determine eligibility, an application must be completed. Once eligibility has been established, the case manager will work with the client to determine what services are needed. Do not use your school's email address If you do not have a personal email address, you can create a free google email address here.Name First Last PhoneAge:(Required)161718192021222324Ethnic Group(Choose one of the descriptions below):American Indian or Alaskan NaveAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhite (Not Hispanic or Latino)Hispanic or Latino(All Races)Race Missing or unknownWage Desired: Date you can start: MM slash DD slash YYYY Email(Required) Enter Email Confirm Email Are you eligible to work in the United States? Yes No Position applying for: Have you applied to this company before? If yes, when and for which position?yesno Referred by: Are you employed? No Yes If yes, may we contact the employer? yes no Work you are available for: Full Time Part-Time Temporary What days or times are you not available to work? Do you live in either Hendry, Collier, Lee, Glades, or Charlotte county? Yes No What is the closest CareerSource Southwest Florida location to your residence?Select oneClewiston centerFort Myers centerImmokalee centerLaBelle centerNaples centerPort Charlotte centerAddress: Street Address City State / Province / Region ZIP / Postal Code What High School are you attending? Which particular service interest you?Find a summer jobFind a permanent jobCareer HelpCareer ExplorationContinuing Higher EducationPart-time summer jobFull-time summer jobDo not want to discloseHow did you hear about the Summer Youth program? check all that apply : Word of Mouth Community Referral School Counselor or Staff Newsletter email Social Media Local Government Google Other Other: Are you registered on Employflorida.com(Required) yes no Register During the Fall Academic year of 2023, what school or secondary program will you attend? Which of the following summer program tracks are you interested in ? Job Shadowing Work Experience-Part-Time Employment Work Experience-Full Time Employment Work Experience-Summer Employment Local Government Permanent Position References: Give below the names of three persons not related to you whom you have known at least one year and have worked with.Name: Address: City: State: Business: Zip: Phone: Δ Share this:Click to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to email a link to a friend (Opens in new window)MoreClick to print (Opens in new window)Click to share on Reddit (Opens in new window)Click to share on Pinterest (Opens in new window)Click to share on Tumblr (Opens in new window)Click to share on Pocket (Opens in new window)
