YCC_2015 Youth APP - Farmington Municipal Schools

2015
YOUTH WORKER
NEW MEXICO YOUTH CONSERVATION CORPS
SUMMER APPLICATION
NAME: ___________________________________________________________________________________
HOME ADDRESS: ________________________________________________________________________
CITY, STATE, ZIP: ________________________________________________________________________
DATE OF BIRTH:_________________________________________________________________________
CONTACT NUMBERS _____________________________home/________________________________cell
PARENT/GUARDIAN NAME: ______________________________________________________________
WHAT SCHOOL DO YOU PRESENTLY ATTEND? __________________________________________
TEACHER FOR RECOMMENDATION:_____________________________________________________
HAVE YOU BEEN A CURRENT RESIDENT OF NEW MEXICO
FOR AT LEAST THE PAST 6 MONTHS?
YES
NO
ARE YOU BETWEEN THE AGES OF 14-19 as of 6/01/15?
YES
NO
ARE YOU ABLE TO BEGIN WORK ON 6/01/15?
YES
NO
ARE YOU ABLE TO WORK FROM 7:00 am-4:00 pm, M-F?
YES
NO
Are you able to possibly work from 7:00 am -5:30 pm M-Th
YES
NO
DO YOU HAVE RELIABLE TRANSPORTATION TO
AND FROM JOB SITES? (Job site 7:00am to 12:00 noon,
YES
NO
and Rocinante High School 1:00pm to 4:00pm.)
THE YOUTH CONSERVATION CORPS IS AN EQUAL OPPORTUNITY EMPLOYER
*This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. Please answer all
appropriate questions completely and accurately. False or misleading statements during the completion of this form are grounds for terminating the
application process or, if discovered after employment, terminating employment. All qualified applicants will receive consideration without
discrimination because of race, gender, marital status, age, creed, national origin, or the presence of a disability. Any conviction will not necessarily
bar an applicant from employment. Individual testing for job-related skill and the presence of drugs in your body may be required prior to
employment. After an offer of employment and prior to reporting to work, you may be required to submit to a medical review including completion
of a medical case history and an examination by a medical professional designated by the district. All applicants for employment will have a
background check review.
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2015
YOUTH WORKER
NEW MEXICO YOUTH CONSERVATION CORPS
SUMMER YOUTH APPLICATION
Please write a statement explaining why you feel you would be an asset to the Youth Conservation Corp team.
(Please include a “willingness to participate” statement, your personal and professional goals, any previous experience
participating in a team environment, any personal qualities and/or qualifications that would contribute to the YCC effort,
and any other information you feel would be appropriate. Attach an additional page if more space is needed.)
____________________________________________________________________________________
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____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
___________________________________________________________________________________
List two adult references. (Do not list relatives.)
Name_______________________________
Name_______________________________
Address_____________________________
Address_____________________________
City_____________________State_______
City_____________________State_______
Phone (____)____________Zip__________ Phone (____)____________Zip__________
Relationship_________________________
Relationship_________________________
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2015
YOUTH WORKER
NEW MEXICO YOUTH CONSERVATION CORPS
SUMMER APPLICATION
I understand that the New Mexico Youth Conservation Corps summer program is a work/educational
program designed to accomplish needed conservation work on public lands and is also designed to provide
a unique environmental learning experience. I hereby certify that all statements made in this application
are true and correct. This application will not be processed without the appropriate signatures. Only
hard copy applications will be accepted. Please, do not email your applications.
Applicant’s Signature____________________________________Date_____________________
Parent’s/Guardian’s Signature_____________________________Date_____________________
Parent’s/Guardian’s Signature_____________________________Date_____________________
Application Deadline: April 10, 2015
Drop Off/Mail/Email Application To: Farmington Municipal Schools
ATTN: Rocky Torres - NMYCC Summer Program
2200 Sunset Ave
Farmington, NM 87401
[email protected]
Interview Schedule:
Applications will be reviewed, and due to the large number of applicants, only selected applicants will be
contacted for an interview. You will be contacted after April 10th via email, so be sure to check your
email regularly. Interviews will take place April 15th 1:00-8:00 pm, and April 16th and 17th 4:00pm-8:00 pm.
_________________________________________________________________________________________
_________________________________________________________________________________________
Please write down any Vacation/Time off you will need to take during June 1- August 1, 2015.
_____________________________________________________________________
_____________________________________________________________________
**VERY IMPORTANT** YOU will need to get a TEACHER RECOMMENDATION. Ask
the teacher you select to complete the recommendation found on the page attached and return
in a sealed envelope to you. Teacher Recommendations must be turned in with your
application.
Teacher’s Name, School & Contact Information___________________________________
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2015 Youth Worker
New Mexico Youth Conservation Corps Teacher Reference
Please complete the recommendation and return to the student in a sealed envelope. This
recommendation will be turned in with their application.
Rocky Torres
2200 Sunset Ave.
Farmington, NM 87401.
Teacher’s Name___________________________________________
Student’s Name____________________________________________
School______________________________________________________
Why do you recommend this student?
______________________________________________________________________________
______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
________________________________________________________________________________
Compared to other high school/middle school students, how do you rate this student in terms
of the following qualities:
Below
Average
Good
Very Good Excellent
Average
Motivation
Self
Confidence
Disciplined
Work
Habits
Leadership
Abilities
Attendance
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