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    VIDOL 2010 Summer Youth Component Registration

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    The Whitaker Consultant Group,LLC
    This document is a registration form for a summer youth program that provides various employment and career services. Applicants are asked to check which services they need help with, including job referrals, unemployment insurance information, vocational training, job skills training, education information, and computer classes. The form requests contact information, demographic details, education and employment history. It explains the applicant will receive documents regarding customer rights, grievance procedures, and a code of conduct upon their interview.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    VIDOL 2010 Summer Youth Component Registration

    Uploaded by

    The Whitaker Consultant Group,LLC
    40 views2 pages
    This document is a registration form for a summer youth program that provides various employment and career services. Applicants are asked to check which services they need help with, including job referrals, unemployment insurance information, vocational training, job skills training, education information, and computer classes. The form requests contact information, demographic details, education and employment history. It explains the applicant will receive documents regarding customer rights, grievance procedures, and a code of conduct upon their interview.

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    This document is a registration form for a summer youth program that provides various employment and career services. Applicants are asked to check which services they need help with, including job referrals, unemployment insurance information, vocational training, job skills training, education information, and computer classes. The form requests contact information, demographic details, education and employment history. It explains the applicant will receive documents regarding customer rights, grievance procedures, and a code of conduct upon their interview.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    40 views2 pages

    VIDOL 2010 Summer Youth Component Registration

    Uploaded by

    The Whitaker Consultant Group,LLC
    This document is a registration form for a summer youth program that provides various employment and career services. Applicants are asked to check which services they need help with, including job referrals, unemployment insurance information, vocational training, job skills training, education information, and computer classes. The form requests contact information, demographic details, education and employment history. It explains the applicant will receive documents regarding customer rights, grievance procedures, and a code of conduct upon their interview.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    Summer Youth Component

    Registration Form 2010


    HOW CAN WE HELP YOU? (Please check all that apply.)

    1. Help finding work / job referrals


    2. Information about Unemployment Insurance (UI)
    3. Information about services for job seekers with disabilities
    4. Help finding a new career that fits my skills and interests
    5. Vocational / occupational training
    I Need: 6. Job search skills (resume writing, how to look for work, interviewing, keeping the job, etc.)
    7. Information about education (GED, high school completion, college)
    8. Computer classes
    9. To improve my basic skills (reading, math)
    10. To learn English
    11. Information about YouthNet and/or Youth services
    12. Referral to other services (child care, transportation, housing, legal, counseling, etc.)
    other:

    LAST NAME: FIRST NAME:


    SOCIAL SECURITY #: Today's Date:
    Street:
    Address:
    City/State: Zip:
    Mailing Street:
    Address:
    City/State: Zip:
    Day Phone: ( ) Alternate Phone: ( )
    E-Mail Address: Gender: Male Female
    Date of Birth: Are you registered for Selective Service? Yes No
    ETHNICITY:
    American Indian/Alaskan Native Hispanic Asian
    Black-not Hispanic White-not Hispanic
    Other Decline to Answer
    EDUCATION STATUS: Highest grade completed: HS Diploma GED College
    Degrees, licenses or credentials you hold:
    EMPLOYMENT STATUS: Are you currently working?:
    If no, what kind of work are you looking for? Or main occupation?
    ADDITIONAL INFORMATION: Ex-offender Yes No
    Veteran of the U.S. Military Yes No Migrant/seasonal farm worker Yes No
    Current or former Foster Youth Yes No Person with a disability Yes No
    Refugee / Asylee Yes No Receiving Unemployment Yes No
    Homeless Yes No Received Unemployment
    Receiving Public Assistance Yes No within past 12 months Yes No
    (GA, TANF, Food Stamps, RCA, SSI) Permanent Alien #:
    VIDOL0001 Revised 05/10 Application continues --------->>>
    WORK HISTORY (Please start with last job held);
    Company: Job Duties:
    Start Date: End Date:
    Job Title 1:
    City/State: Reason for Leaving:
    Hourly Wage: $ FT PT Separation Pay/Ltr: Yes No

    Company: Job Duties:


    Start Date: End Date:
    Job Title 2:
    City/State:
    Hourly Wage: $ FT PT Reason for Leaving:

    Company: Job Duties:


    Start Date: End Date:
    Job Title 3:
    City/State:
    Hourly Wage: $ FT PT Reason for Leaving:

    You will receive upon your interview: 1) Customer Bill of Rights 2) Grievance Procedure and; 3) Code of Conduct. I certify that the
    information provided is true to the best of my knowledge. I am also aware that the information I have provided is subject to review and
    verification and that I may have to provide documents to support this application.

    Signature: Date:

    Parent/Guardian Signature:_____________________________ Date:

    *** FOR OFFICIAL USE ONLY ***

    Right-to-Work Documents Viewed: Staff Initials:

    AOSOS Customer ID Assigned: Date:

    - CUSTOMER REFERRAL / ACTION PLAN -

    TALENT DEVELOPMENT TALENT MARKETING

    Pre-Employment Skills Workforce Intelligence


    Soft-Skills Resume Assistance
    Basic Skills Interviewing Assistance
    Workforce Intelligence Job Matching / Referrals
    Computer Literacy Pre-screening / Referrals
    Career Assessment Job Fairs
    In-depth Skills Assessment Employment Networking
    Career / Technical Education Job Coaching / Career Counseling
    Vocational Training Employer Orientations / Interviews
    On-line Training / Distance Learning
    Tuition Assistance
    Subsidized Employment
    Support Services

    The Virgin Islands Department of Labor is an Equal Opportunity Employer/Program with Equal Opportunity Programs.
    Auxiliary aids and services are available upon request to individuals with disabilities

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