High School. Diploma AND Construction Training. If you re and ready to take your life to the next level, Venice YouthBuild is here to help!

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1 If you re and ready to take your life to the next level, Venice YouthBuild is here to help! Earn your High School PROGRAM STARTS SOON! Info Sessions Each Tuesday at 11am Diploma AND Construction Training with: *Job Readiness Skills *Leadership Development *Career Counseling *College Support Venice Community Housing 720 Rose Avenue. Venice CA, Come to the office or CONTACT MARISOL Visit Venice YouthBuild on Facebook or at vchcorp.org

2 Venice YouthBuild is a 10-month, comprehensive leadership program for young adults y/o, providing hands-on construction training, high school diploma prep, counseling, and pathways into careers. Within the Venice YouthBuild program, youth participants gain the skills and confidence needed to be competitive within today s job market as well as become empowered to take on future life challenges and reach their full potential. The program offers the following resources to guide participants towards personal success and community improvement: High School Diploma/GED Prep through an onsite partnership with John Muir Charter School, participants earn their high school diplomas or GEDs through group & individual instruction Construction/Vocational Instruction in the classroom/construction shop participants learn basic construction skills & safety and work towards an industry-recognized PACT certification, as well as get hands-on construction training by building affordable housing Life Skills/Case Management participants receive life skills classes and individual case management & counseling to identify obstacles and overcome barriers in areas such as transportation, housing, (mental) health, legal, substance dependency, and healthy relationships Career Counseling/Placement/Graduate Services participants receive individualized career counseling, prepare to enter career paths, and upon graduation are provided one year of follow-up services Leadership Development at the core of the YouthBuild experience participants engage within local/national politics, leadership activities/workshops, and perform extensive community service To apply or for more information please go to or contact Administrative Coordinator, Marisol Perez at (310) Urgent Need for Education and Workforce Training: Throughout California, youth ages are neither in school nor employed, and as of 2009, the Los Angeles Unified School District had a graduation rate of only 45.6%. Over 90% of the youth chosen to participate in Venice YouthBuild did not finish high school; 20% are court-involved; and many struggle with substance dependency amongst other obstacles. Venice YouthBuild helps opportunity youth reconnect to gainful futures by assisting them to earn high school diplomas, work experience, and advancing them into career pathways. Equal Opportunity Employer/Program. Auxiliary aids and services are available upon request to individuals with disabilities. VENICE COMMUNITY HOUSING CORP ROSE AVENUE, VENICE, CA PHONE FAX

3 VENICE YOUTHBUILD DOCUMENTATION CHECKLIST PROOF OF IDENTIFICATION AND AGE Please bring one of the following: Driver s License United States Passport Government ID Naturalization Certificate Birth Certificate PROOF OF ELIGIBILITY TO WORK IN THE UNITED STATES Please provide one of the following: Social Security Card Other documentation that proves you are able to work in the US HIGH SCHOOL DOCUMENTS Please bring all of the following, if applicable: High School Transcripts (mandatory) Transcripts from Incarceration Periods (only if this is applicable) IEP Documents (only if this is applicable) PROOF OF INCOME Please bring one of the following: Income Tax Return Public Benefits Letters or Documents for: Pay Stub Food Stamps CalWORKS GR SSI PROOF OF RESIDENCE Please bring ANY bill that matches the address you provided on the YouthBuild application DOCUMENTS FROM PAROLE/PROBATION OFFICER (This section only applies to those who are currently on probation or parole) Please bring a letter from your probation or parole officer that states: Type, Cause, and Duration of Probation or Parole Period

4 VENICE YOUTHBUILD PROGRAM APPLICATION APPLICANT INFORMATION Last Name: First: M.I.: Date: Street Apt #: Social Security #: City: State: Zip: Home Cell Date of Birth: Age: Ethnicity (Please check all that apply) Asian American Indian/Alaska Native Black or African American Hawaiian Native or other Pacific Islander Hispanic or Latino White Other (please specify) Are you a citizen of the United States? Yes No If no, are you a permanent resident? Yes No A Registration Number: Are you a US Veteran? Yes No Guardianship Information (if under 18) Name(s): Phone Number(s): EDUCATIONAL HISTORY High School Diploma Yes No GED Yes No Date Received: Highest Grade Completed 9 th 10 th 11 th 12 th Date Last Attended: High School Attended: From To High School Attended: From To EMPLOYMENT HISTORY Employer: Supervisor: From To Responsibilities Employer: Supervisor: From To Responsibilities: COMMUNITY ACTIVITIES Please list any in which you have been involved: Revised 05/18/2016

5 FAMILY STATUS Married Yes No Single Yes No If you do have a child or children, please list their ages: Do you have any children? Do you have custody of your child/children? Yes No Do your children live with you? Yes No Yes No CRIMINAL HISTORY Do you have a criminal record? Yes No If yes, is it juvenile? Yes No If not juvenile, is it an adult record? Yes No Are you on probation or parole? Please provide the following information if you are on probation or on parole Name of Probation or Parole Officer Yes No MEDICAL HISTORY Do you have any medical condition that you believe would prevent you from participating in any aspect of this program? If yes, please explain. SOURCE OF FAMILY INCOME (CHECK ALL THAT APPLY) No Income CalWORKs (AFDC) SSI Social Sec General Assist Food Stamps Veteran s Benefits Employment Only Unemployment Benefits Number of family members, including applicant: Total Annual Household Income $ REFERRAL SOURCE (CHECK ALL THAT APPLY) Staff/Recruiter YB Participant Family/Friend Public Transport: WorkSource Probation/Parole Online: Mall Other: Applicant Statement: I understand that this eligibility certification form is a legal document and certify that the information on this form is true to the best of my knowledge. I acknowledge that such information is subject to verification and that falsification of the form shall be grounds for termination from the program. All such information will be kept confidential. Applicant s Signature: Date: Submit to: Venice Community Housing or Marisol Perez 720 Rose Ave Venice, CA marisol@vchcorp.org 2 Venice YouthBuild is affiliated with YouthBuild USA and AmeriCorps. Equal Opportunity Employer/Program. Auxiliary aids and services are available upon request to individuals with disabilities.