OC Young Adult Careers Interest Form
Thank you for your interest in OC Young Adult Careers, a County of Orange sponsored program. Please complete the form and a staff member will be with you soon! If you need assistance, please text us at 657-210-1295. Please visit www.ocwib.org/young_adult for eligibility requirements.

If you are a permanent resident of Anaheim or Santa Ana, please visit the Anaheim Jobs Center or the Santa Ana Work Center for assistance.

First Name *
Your answer
Last Name *
Your answer
Age *
Your answer
Education Status *
E-mail
Your answer
Street Address
Your answer
City
Your answer
Zip Code
Your answer
Phone Number
Your answer
Preferred Method of Contact *
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Individual's Certification and Agreement
By submitting this form, I hereby certify that the facts set forth in the above interest form are true and complete to the best of my knowledge and authorize OC Young Adult Careers to verify their accuracy. I hereby release OC Young Adult Careers from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an enrollment decision based on such information.

I understand that, if enrolled, falsified statements of any kind or omissions of facts called for on this interest form shall be considered sufficient basis for dismissal from enrollment.

I understand that should an enrollment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of OC Young Adult Careers. However, I further understand that neither the policies, rules, regulations or anything said during the enrollment process shall be deemed to constitute the terms of an implied enrollment. I understand that any enrollment offered is for an indefinite duration and at will and that either I or OC Young Adult Careers may terminate my enrollment at any time with or without notice or cause.

This WIOA Title I financially assisted program or activity is an equal opportunity employer / program. Auxiliary aids and services are available upon request to individuals with disabilities. OC Young Adult Careers is a proud partner of America’s Job Center of California℠ network.
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