Summer Health Education Project (SHEP) Application 2019
SHEP members receive comprehensive health outreach training about on-site services, public speaking, project and planning implementation, healthy relationships, STI and HIV prevention, nutrition, reproductive health, & diversity and group facilitation. SHEP represents 3rd Street Youth Center & Clinic by conducting outreach and spreading information learned, throughout the community, via social media, tabling events, and street outreach. Participants will earn a stipend for the duration of the program.

Applications for SHEP are due Monday, May 13th, 2019 @5:00 PM
SHEP members begin Tuesday, June 18, 2019 @1:00 PM
Upon application submission, scheduled interview slots will be assigned

Applications can be submitted via in-person, email or this online form.

Email: ashia@3rdstyouth.org

In-Person:
Ashia Coleman
1728 Bancroft Ave
San Francisco, CA 94124

Participant Expectations:
-Consistent attendance to workshops
-Help educate 100+ youth through outreach activities including: tabling events, workshops, and street outreach.
-Youth is responsible for keeping up with administrative work assigned to projects, classes, workshops, and outreach. Example: flyers, sign in sheets, final project

Qualifications:
-Youth must be 12-16 years old
-Youth must be able to commit to 3 days a week,: Tuesday-Thursday, from 1-3pm as well as a few special occasions outside the normal hours (weekends, holidays, events, festivals, etc.)
-Youth must commit to full 8 week semester
-Youth must have an interest in health advocacy and community outreach

Email address *
Applicant Information
Full Name *
Your answer
Preferred Name
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Cell Phone Number *
Your answer
Email Address
Your answer
Have you ever participated in a 3rd Street program? *
If yes, which one and when?
Your answer
Do you have any plans this summer that will interfere with the SHEP schedule? (vacations, jobs, camps, other programs). If so, please tell us the dates and times. If no, please say so. *
Your answer
Education
Name of your middle school & years you attended: *
Your answer
If in high school, name the high school you attend.
Your answer
Applicant Questionnaire
Please complete this to the best of your abilities. You must write at least two sentences for each question.
Tell us about your yourself: *
Your answer
Describe the biggest issue in your community & what changes you would like to make: *
Your answer
What does community advocacy and outreach mean to you? *
Your answer
What do you know about the services at 3rd Street Youth Center & Clinic? *
Your answer
Why are you interested in a summer job at 3rd Street? What do you want to gain from this program? *
Your answer
Disclaimer & E-Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to program enrollment, I understand that false or misleading information in my application or interview may result in my release from programming.
Enter your initials to serve as your e-signature *
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of 3rd Street Youth Center & Clinic.