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Operation Amani – Life Coach/Case Manager Job Application Form
Thank you for your interest in supporting youth and young adults in our community. Please fill out the form below.
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Full Name
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Date of Birth
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Phone Number
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Email Address
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Street Address
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City
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State
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Zip Code
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Are you available to work evenings and weekends?
Yes
No
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Preferred Start Date
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DD
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YYYY
Highest Level of Education Completed
High School Diploma
Associate’s Degree
Bachelor’s Degree
Master’s Degree
Other
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If other, please specify:
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School Name
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Field of Study (if applicable)
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Graduation Year
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Do you have a valid driver’s license?
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No
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Do you have any certifications related to life coaching or mentoring?
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No
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If yes, please list your certifications:
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Employment History 1: Job Title
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Employment History 1: Employer
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Employment History 1: Dates of Employment
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Employment History 1: Key Responsibilities
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Employment History 2: Job Title
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Employment History 2: Employer
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Employment History 2: Dates of Employment
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Employment History 2: Key Responsibilities
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Do you have experience working with youth ages 14–25?
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No
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If yes, please briefly describe your experience:
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Please check all that apply to your skillset:
Goal setting and life planning
Mentoring and coaching
Teaching life skills (time management, communication, etc.)
Providing emotional support
Connecting youth to community resources
Facilitating group discussions/workshops
Conflict resolution and behavioral guidance
Record keeping and progress tracking
Why are you interested in the Life Coach/Case Manager position at Operation Amani?
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Describe a time you supported a young person through a personal, academic, or career challenge.
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Reference 1: Name
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Reference 1: Relationship
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Reference 1: Phone/Email
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Reference 2: Name
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Reference 2: Relationship
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Reference 2: Phone/Email
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Are you willing to undergo a background check?
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No
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