Seven Hills Neighborhood Houses

Seven Hills provides summer youth employment giving youth between the ages 14 and 21 an opportunity to enhance their employability skills. This program serves 60 to 100 youth. Year around funding is being sought for 2007. Job readiness, job placement and follow up case management are provided. Local businesses sign agreements to provide supervision to youth placed with their company. Salaries for youth are included as a part of the grant. This program historically is funded through Hamilton County Jobs and Family Services. Although multi locations are used to provide orientation and job sites, Findlay Street Neighborhood House is the agency’s site of operation.

Teenagers between the ages of 14 and 17 interested in becoming a Teen Advocate are welcome to copy and fill out the following application and returning it to 901 Findlay Street or emailing it to alexis.kidd@7hillsnh.org. Spaces are limited and teens that participate must demonstrate a levle of excellence in academics, attitude, and attendance.

Drug Prevention Program

Teen Advocate Application

Text Box:

Seven Hills Neighborhood Houses

Teen Advocates Application

Funded by the City of Cincinnati

Application Date:

First name Middle Name Last Name

Home Address City/State Zip

Telephone Cell Telephone

Social Security # Date of Birth Age Sex

City, State of Birth

Email Address

Race (check one) African American Multiracial Asian American Native American/Alaskan European American

Ethnicity (circle if applicable) Appalachian Hispanic/Latino Other _____________

Disabilities (circle if applicable) Ambulatory/physical Cognitive/Mental Other ______________

SCHOOL INFORMATION

Are you currently attending school? If yes, where

Grade: Major:

If not in school, last school attended: Last grade completed

Have you passed 9th/10th grade proficiency? Circle sections passed: Math Science Reading Writing Citizenship

Have you been suspended or expelled from school in the last year? 5 Yes 5 No IEP or 501 Plan? 5 Yes 5 No

Total number of members living in household _______

VOLUNTEER AND WORK HISTORY

Are you now, or have you ever been in a job readiness job training program? 5 Yes 5 No

If yes list agency:

What was the name and location of your worksite?

Would you be interested in returning to the same site?

If no, why?

List any volunteer or work history starting with your most recent position. Attach an additional sheet if the following space is not sufficient.

Company Name Start Date End Date

Address Start Salary End Salary ___________

City, State, Zip Code Job Duties

Supervisor Name Telephone ( ) _________________

Email Address

Job Title Reason for Leaving

Company Name Start Date End Date

Address Start Salary End Salary ___________

City, State, Zip Code Job Duties

Supervisor Name Telephone ( ) _________________

Email Address

Job Title Reason for Leaving

REFERENCES

References must be an adult that will fairly assess your work ethic, character, and ability to serve as a Teen Advocate.

Name: _____ Address: __________

Phone:

Name: _____ Address: __________

Phone:

Name: _____ Address: __________

Phone:

RESIDENCY ELIGIBLITY

Do you meet one or more of the following categories (Please check all that apply)?

School Dropout 5 Homeless 5 Runaway 5 Held back a Grade 5

Pregnant/Parent 5 Foster Child/Ward of the State 5 Juvenile Offender 5

Are you a citizen of the United States? Yes 5 No 5

Do you live inside the City of Cincinnati? Yes 5 No 5

Do you live inside Hamilton County? Yes 5 No 5

INTEREST:

Check all types of positions that you are interested in working.

Applicants:

Clerical/Office 5 Maintenance/Janitorial 5 Retail 5 Hair Salon 5

Child Care 5 Landscaping/Yard Work 5 Art 5 Food Service 5

Computer5 Recreation 5 Music 5

Other:

Please specify your top three work-site preferences (Findlay Street, Hays Porter School, Riverview East Academy, WEB Dubois Academy).

Choices: #1 #2 #3

What is your favorite subject school?

What are your interests and hobbies? __________________________________________

________________________________________________

What are your career goals?

________________________________________________

Do you plan to go to college or vocational school?

________________________________________________

If yes, what do you want to study or major in?

________________________________________________

How did you hear about this program?

Certification and Authorization – Read Carefully

I certify that all facts contained in the application are true and complete, I authorize Seven Hills Neighborhood Houses to verify the accuracy of the information provided herein, and I authorize former employers and educational institutions to release information concerning me to Seven Hills Neighborhood Houses Teen Advocate Program. I understand that falsification; misrepresentation or omission of requested facts may result in denial of employment or, if employed, may result in immediate dismissal. I understand that the Teen Advocate position is a program that provides teenagers with an opportunity to perform community service. The service that I provide is seen as volunteer and service learning. I understand and agree that I am a volunteer, and that if accepted, service will be for no definite periods and may, regardless of the date of stipend disbursement, be terminated at any time without previous notice and with or without reason, at the will of the site coordinator, myself, or Seven Hills.

Applicant Signature: Date:

Parent’s Signature: Date:

01/09SHNH