Youth Employment Services 2022 Interest Form - VPS
Thank you for your interest in YES 2022. Please respond to each question to the best of your ability. A member of the YES team will connect with you to discuss the program and the application process.

Please reach out to Becky Mohagen (becky.mohagen@esd112.org) or Nathan Abbott (nathan.abbott@esd112.org) with any questions or concerns.
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What is the student's first name? *
What is the student's last name? *
Please select the services the student would like to access. (students must be at least 14 years of age to participate in training and 16 years of age to participate in a paid internships)
What school does the student attend? *
What is the student's grade? *
What is the student's date of birth? *
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To participate, students must have an IEP, a 504 Plan, or a documented disability. Does the student meet this criteria? *
Who is the student's Counselor or Special Education teacher?
What is the student's Counselor or Special Education teacher's email?
What is the student's email address?
What is the student's phone number?
What is the parent/guardian's name? *
What is the parent/guardian's email address? *
What is the parent/guardian's phone number? *
Please enter any questions or comments below. We will discuss them when we meet.
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