CSC 2014
Summer Youth Employment Program

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● ● CLOSED ● ●
We are no longer accepting applications.

●   Applications are not currently being accepted.   ●

●   The next program will start in January, 2015.   ●

●   You can only apply ONE time.  ●

● OUR SLOTS ARE LIMITED. If you are selected to complete the second stage of the enrollment process CareerSource Broward (WF1) will mail you an eligibility packet to your home address. It is your responsibility to enter the CORRECT ADDRESS to receive this packet on time. There will be a deadline in which you must return the packet to WF1. ( )

● A non-expired Photo ID and a Social Security Card are MANDATORY for all participants at their eligibility interview. (Copies of either document will NOT be accepted.) If you do not currently have a proper ID or Social Security Card, we recommend you request one at this time. You WILL NOT be allowed to complete your eligibility process without these and any other requested documents. In some cases, you may be required to provide additional forms of ID. You are also required to personally appear for your Eligibility Interview if you are selected to complete the second stage of the enrollment process. ( )

● Please complete all fields as accurately as possible. All statements made on the application are subject to review and verification. Exaggerated, false, or misleading statements may be cause for rejection of the application and/or termination from the Summer Youth Employment Program (SYEP). ( )

● Eligibility is limited to Broward County participants who have turned 16 on or before the program begins, on 6/9/2014, and have not turned 19 on the day the program ends, 8/5/2014.

Personal Information

First Name: MI: Last Name: (Jr, Sr, III):
Social Security Number:   Date of Birth: Age:  
Your birthday must be between 08/6/1995 and 06/9/1998 (inclusive). A valid I.D. will be required.
Are you legally able to work in the U.S.?
If you are not a U.S. Citizen you must provide proof of current eligibility to work in the U.S., i.e. Permanent Resident Card, Alien Registration Receipt (Form I-551), Employment Authorization (Form I-766, Form I-94 or I-94A). If you cannot provide any of the above you will not be able to participate in the program.

Address/Contact Information

!! This is the address your packet will be mailed to if you are selected for the program.
Incomplete or inaccurate information will prevent your packet from reaching you and result in disqualification.

You must be a Broward County Resident
  Apt/Bld Number:  (Example: BLD 102 APT 235)  
    Apt/Bld Number:  
City:         State:     Zip:    
Your Home Telephone Number:     Email Address:  
Your Cell Phone Number:   Verify Email Address:  
Twitter: Facebook:

Parent or Guardian's Contact Information

Parent or Guardian's Name:   Telephone Number:    
Cell Phone: Email Address:

Demographic Information

School Identification Number (Student ID#):  
What is the Name of the School you attend?  
What grade will you be in August 2014?  
Home Arrangement:  
Household Income:  
Country of Birth:  
Language Spoken at Home:  
Cultural Influence:  

Work Experience Information

Worksite assignment preference (City):  
How do you plan to get to your worksite?  
List Any Languages Other Than English You Speak:
What type of work experience would you prefer:  
Select your best skill/interest:
(Not required, but in some cases it may help us in matching you to a particular job. Indication of a special skill does not guarantee a position utilizing that skill)
  Select all that apply to you. Doing so will help us to match you to work experience suitable to your unique needs and background.
  (We will ask for verification)

Other Information

Have you been CONVICTED of ANY violation of the law, other than minor traffic offenses, or pleaded NOLO CONTENDERE to criminal charges, even if adjudication was withheld?  
NOTE: An arrest or conviction does not automatically disqualify you from participating in the work experience program. Some worksites are not allowed to employ individuals with certain offenses. Your information will make it easier for us to develop appropriate jobs and to be able to place you if you are selected.
  (It will be verified)
Please:  Click the Submit button only ONCE.
Make sure all your information is correct BEFORE you click Submit.
I understand that if my address is not complete and accurate I will NOT be selected or contacted: ()
I have double checked my address and it is correct: ()
All information on this form is correct and accurate: ()

Submission of this Application does NOT guarantee that you will be contacted or offered a job.
● If the "Submit" button is not active or greyed out be sure you read the instructions at the top of the page! ●

You will receive a packet in the mail if you have been selected to participate in the program. If your address changes at any time please call (954) 202-3830 and the administrative assistant will transfer you to a mailbox where you will leave your first and last name with new address and phone number where you can be reached. Please check out website or call the Hotline at (954) 202-3838 for any questions and all updates regarding Summer Youth Employment Program (SYEP). Please DO NOT CALL to check if you were selected!!
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