Pre-Apprenticeship Program Application
Thank you for your interest in the YCAL Pre-Apprenticeship Programs. If you have not done so already, it is highly recommended that you visit www.ycal.us/preapprenticeship and discuss the requirements with your parent or guardian, and your school/career counselor at your high school before completing this application. Please see the application requirements listed below and do not complete the application until you feel you can commit to the items listed.
Program Information
Please select the program that you are interested in pursuing
Please confirm the area of Pre-Apprenticeship that you would like to pursue *
Contact Information
Please enter the following information about yourself:
First Name *
Last Name *
Phone # (XXX-XXX-XXXX) *
Please list the best number to reach you (Cell phone preferred) Please Note: Your number will only be used to contact you if there is an issue regarding your application, or to inform you of a schedule change if made within 24 hours of your meeting)
Please provide your DATE OF BIRTH *
MM
/
DD
/
YYYY
Please select your cell phone carrier from the list below *
Please provide your EMAIL ADDRESS *
Please make certain this is an address that you check frequently
Please CONFIRM your EMAIL ADDRESS *
Please make certain this is an address that you check frequently
Please select the school that you attend *
Please note that the person listed next to your school is the primary YCAL contact
What is your CURRENT grade level? *
Please select your CURRENT grade level. Please note that for the Kinsley Pre-Apprenticeship, when applying you must be a current Junior who will be considered a Senior the year that you will be participating in the program.
Please tell us how you learned about the Pre-Apprenticeship Program *
Select the best option from the list below (you may select multiple responses if applicable)
Required
Emergency Contact Information
Please enter information for AT LEAST ONE (1) adult (preferably a parent/guardian) that can serve as an emergency contact.
Emergency Contact #1's First Name *
Emergency Contact #1's Last Name *
Emergency Contact #1's Phone Number *
(Please provide the number that is the BEST number to reach him/her immediately)
Emergency Contact #2's First Name
Emergency Contact #2's Last Name
Emergency Contact #2's Phone Number
(Please provide the number that is the BEST number to reach him/her immediately)
Medical Information
Please provide the following information in order for us to be prepared for any potential medical, dietary, or other special accommodations you may require to complete this program.
Do you have any medical conditions that may require attention throughout the course of this program (e.g. Asthma, Food Allergies, Other Allergies, Hearing or Vision Impairment, etc) *
If Yes, please select "Other" below and describe the condition and any information we should be aware of.
Do you require medication that may need to be taken or administered throughout the course of this program (e.g. Inhaler, Insulin injection, EpiPen) *
If Yes, please select "Other" below and describe the medication that you may require.
Do you have any dietary restrictions for medical, religious, or other purposes?
If No, leave blank. If Yes, please describe the dietary restriction (Occasionally program sponsors will provide a snack or lunch and it is very useful to know this information)
Please give a brief description (approximately one paragraph) explaining why you would like to pursue this field of Pre-Apprenticeship *
Please be aware that the hosts of the program will see what you write in this space, so please use well-formed sentences and pay attention to your grammar and punctuation
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy