Youth Employment Program - Student Application 2025 June 16th-August 25th
Email *

2025 Youth Employment Program Employee Application

Please read & return to The Highland Center or send via email by May 12th, 2025

The Highland Center’s Youth Employment Program (YEP) is a work and learning experience. You are required to attend Orientation and complete all necessary paperwork to participate in the program.

NOTE: Fill in all blanks. If the info asked for does not apply to you put “does not apply” on the line. 

If an application is not completed it will receive lesser priority or may not be able to be considered. Parental signature is mandatory unless you are 18, and you must list an active e-mail address.

Applicant's Full Name  *
Current Grade Level *
Applicant's Age *
Date of Birth *
MM
/
DD
/
YYYY
Home/Physical Address *
Mailing Address *
Home Phone *
Cell Phone *
Email Address *
Do you live in Highland County full time? *
Required
Parent/Guardian's Full Name *
Parent/Guardian's Home Phone *
Parent/Guardian's Cell Phone *
Parent/Guardian's Email Address *
Parent/Guardian's Relationship to You *
Parent/Guardian's Place of Employment *

Are there any days/dates you might be unable to work? 

Note: The program runs June 16th – August 25th

Have you ever been fired from YEP or any other job?

 *
Required

If yes, explain why.     

Are you currently a Foster Child? 

 *
Required

Work Experience

Tell us about your previous work experience.  Please list most recent work experience first and attach a resume if you have one.

1. Previous Work Experience (please answer the questions below in order)

Business/Employer's Name: 

Supervisor's Name:

Telephone:

Dates Employed:  

Duties:

2. Previous Work Experience (please answer the questions below in order)

Business/Employer's Name: 

Supervisor's Name:

Telephone:

Dates Employed:  

Duties:

Volunteer Experience

Tell us about your volunteer experience.

1. Volunteer Experience (please answer the questions below in order)

Nature of Volunteer Work:

Supervisor's Name:

Telephone:

Dates Employed:

Duties:

2. Volunteer Experience (please answer the questions below in order)

Nature of Volunteer Work:

Supervisor's Name:

Telephone:

Dates Employed:

Duties:

More About You!
Please list your hobbies and work interests *
What type of work environment do you prefer? List most preferred first (office, outside, restaurant, etc).
 *

PARENTAL VERIFICATION: I certify that the information provided about my child is true to the best of my knowledge.

 I am aware that if the information I have provided is false, my child will be subject to immediate termination and that I may be prosecuted for fraud and/or perjury. I allow release of this information for verification purposes and understand that it will be used to determine eligibility. If the applicant is selected, I give permission for his/her enrollment in the Youth Employment Program.

 *
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