TCY Employment Application
In addition to this application, TCY must receive, either via mail or e-mail, a letter of interest and resume in order for your application process to be considered complete.
Your Information
Full Name *
Street Address *
City *
Postal/Zip Code *
State/Province *
Country *
Email Address *
Phone Number *
Which position are you applying for? *
When are you interested in starting?
Clear selection
Please indicate how you heard about this opening *
Are there any other names under which you have worked or attended school? *
If you answered 'Yes' to the above question, list name(s) below.
Additional Information
Are you at least 18 years old? *
Are you legally eligible to work in the United States? *
Do you have any pending arrests or have you ever been convicted of a crime?  *
If you answered 'Yes' to the above question, please describe the nature of the charges/conviction.

*A criminal conviction will not automatically exclude the applicant from consideration for employment, as only convictions that are substantially related to the job the person is applying for are legitimate reasons for disqualification.
Do you have a valid driver's license? *
Background Checks *
I grant permission for TransCenter for Youth to conduct a background check on me upon initiation of employment. I understand such measures are taken to establish and ensure the safety of all employees and participants.
Skills and Experience
Please rate your skills and experience. Use the rating scales below to summarize your training and experience on each of the categories listed. Please answer as honestly as possible, and feel free to add brief comments at the end.
Teaching Experience (Grades K-12) *
Choose the response that best describes your experience.
Working in an Urban Setting *
Choose the response from the list that best describes your experience.
Social Justice Experience *
Choose the response that best describes your experience.
Spanish Speaking *
Choose the response from the list that best describes your experience.
Please list any relevant certifications below.
Certification 1
Is Certification 1 current?
Certification 2
Is Certification 2 current?
Certification 3
Is Certification 3 current?
Are you willing to pursue any trainings and/or certifications that will help you in this position? *
Reference 1 *
Provide first/last name, email address, phone number, and relationship to reference.
Reference 2 *
Provide first/last name, email address, phone number, and relationship to reference.
Reference 3 *
Provide first/last name, email address, phone number, and relationship to reference.
Voluntary Self-Identification Survey

Our company is an Affirmative Action/Equal Employment Employer and as such, we are required to collect and maintain information related to applicants in order to meet governmental record keeping and reporting requirements and to monitor the effectiveness of our outreach, recruitment and other employment practices. 

At this time, we are asking you to help us meet our obligations by providing the information listed on the following questions. Please note that the information will be used only in accordance with the provisions of applicable laws, executive orders, and regulations. Providing this information is voluntary and refusal to so will not result in any adverse treatment. The information you provide will be held in strict confidence except that:

1) Necessary management and supervisory personnel may be informed to ensure proper placement and to provide reasonable job accommodations;

2) First aid and safety personnel may be informed to the extent appropriate, if the condition might require emergency treatment; and

3) Government officials investigating affirmative action program compliance may have access to reported information. 

Thank you for your cooperation in this important initiative.

TransCenter for Youth abides by the requirements of federal laws which prohibit discrimination of individuals with the following legally protected status: race, color, religion, sex, sexual orientation, gender identity, national origin, disability and protected veterans. TransCenter for Youth also abides by affirmative action requirements to employ and advance in employment qualified individuals without regard to race and sex (per Executive Order 11246), disability (per 41CFR 60-741.5(a),and protected veteran status (per 41CFR 60-300.5(a).

Race - Do not respond if you selected Hispanic or Latino above
Clear selection
Protected Veterans

The definitions of protected veterans are listed below. Use the boxes following the definitions to indicate whether you are a protected veteran

Disabled Veteran - A “disabled veteran” is one of the following:

A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service- connected disability.

Recently Separated Veteran - A “recently separated veteran” means any veteran during the three-year period
beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval, or air service.

Active Duty Wartime or Campaign Badge Veteran - An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a
campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

Armed Forces Service Medal Veteran - An “armed forces service medal veteran” means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
Veteran Status:

If you are a disabled veteran, you may choose to use the space below to tell us about:

1) Any special methods, skill, and procedures which qualify you for positions within TransCenter for Youth so that you can be considered for any positions of that kind, and

2) We will make reasonable accommodations to qualified disabled veterans to ensure equal employment opportunity for all.  If, because of your disability, you require a reasonable accommodation such as a change to application or work procedures, documents in an alternate format, sign language interpreter, or specialized equipment which would enable you to engage in the application process or perform the job properly and safely.

Disability Status:

We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years.

Completing this question is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at

How do you know if you have a disability?

A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:

-Alcohol or other substance use disorder (not currently using drugs illegally)

-Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS

-Blind or low vision

-Cancer (past or present)

-Cardiovascular or heart disease

-Celiac disease

-Cerebral palsy

-Deaf or serious difficulty hearing


-Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders

-Epilepsy or other seizure disorder

-Gastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndrome

-Intellectual or developmental disability

-Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD

-Missing limbs or partially missing limbs

-Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports

-Nervous system condition, for example, migraine headaches, Parkinson’s disease, multiple sclerosis (MS)

-Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities

-Partial or complete paralysis (any cause)

-Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema

-Short stature (dwarfism)

-Traumatic brain injury

Do you have a disability? *
Thank you for taking the time to apply and for your interest in working with the TransCenter for Youth team. Please send a brief cover letter and your resume to to complete your application.
Equal Employment Opportunity
TransCenter for Youth is an equal opportunity employer and believes in equal opportunity for all employees and applicants. Accordingly, all employment decisions are based on the principles of equal opportunity. These decisions include recruitment, selection, promotion, transfer, discipline, compensation, benefits, training, and other personnel actions involving persons in all job titles and shall occur without regard to race, color, creed, religion, sex, marital status, pregnancy (including childbirth and related conditions), age, ancestry, national origin, disability, genetic information, veteran or military status, sexual orientation, gender identity, arrest and conviction records, the use or nonuse of lawful products off the employers’ premises during nonwork hours, declining to attend meetings or participate in communications about religious or political matters, or any other characteristic protected by law.

Clear form
Never submit passwords through Google Forms.
This form was created inside of TransCenter for Youth. Report Abuse