2016 New Castle County Summer Youth Employment Program

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Thomas P. Gordon County Executive Sophia Hanson General Manager 2016 New Castle County Summer Youth Employment Program Thank you for your interest in the 2016 New Castle County Summer Youth Employment Program. The New Castle County Summer Youth Employment program is open to all New Castle County youth ages 14-20 years old. Bring your completed application AND required documents to New Castle County s Application Processing Event on Saturday, March 19, 2016 from 9:00 am 3:00 pm. ALL APPLICANTS MUST ATTEND THIS EVENT IN ORDER TO BE CONSIDERED FOR THE PROGRAM!! The Application Processing Event on March 19, 2016 will be held at Garfield Park Community Recreation Center/New Castle PAL, located at 26 Karyln Drive New Castle, DE 19720.

Thomas P. Gordon County Executive Sophia Hanson General Manager 2016 New Castle County Summer Youth Employment Program Application Processing Event Saturday, March 19, 2016, 9AM - 3PM Garfield Park Community Recreation Center/New Castle PAL 26 Karlyn Drive New Castle, DE 19720 ALL APPLICANTS MUST ATTEND THIS EVENT IN ORDER TO BE CONSIDERED FOR THE PROGRAM!! The 2016 New Castle County Summer Youth Employment Program, for income-eligible youth ages 14 20, runs from June 20 through August 26, 2016. Beginning February 8, 2016, applications will be available online at www.nccde.org/syep or available for pick up at the following New Castle County facilities: Gilliam Community Services Building, 77 Reads Way, New Castle, DE 19720 Appoquinimink Library, 651 N. Broad Street, Middletown, DE 19709 Corbit-Calloway Memorial Library, 115 High Street, Odessa, DE 19730 Call (302) 395-5600 for more information www.nccde.org/syep

Thomas P. Gordon County Executive Sophia Hanson General Manager 2016 New Castle County Summer Youth Employment Program APPLICATION REQUIREMENTS & DOCUMENTATION CHECKLIST **NOTE: PLEASE PROVIDE COPIES OF ALL BELOW REQUIRED DOCUMENTATION** In order for your application to be processed, proof and documentation of age, social security number and income status are REQUIRED. Please find the list of acceptable documentation below. If documentation is not listed below, it cannot be used. Please bring copies of the required documents with you. APPLICATION: Completed and signed Summer Youth Employment Program Application FOR PROOF OF AGE, ONE OF THE FOLLOWING IS ACCEPTABLE: Birth certificate State-issued driver s license State-issued photo ID Documentation from school officials with birth date FOR PROOF OF SOCIAL SECURITY NUMBER, ONE OF THE FOLLOWING IS ACCEPTABLE: Social Security Card Employment records Letter from Social Security Administration with SS# Signed documentation from school officials with SS# FOR PROOF OF INCOME STATUS, ONE OF THE FOLLOWING IS ACCEPTABLE: 2015 W-2 Copy of three (3) most recent pay stubs IF APPLICABLE PLEASE PROVIDE THE FOLLOWING DOCUMENTATION; Agency letter verifying Social Security, pension/retirement pay, disability, annuities, child support, unemployment, Medicaid, TANF, food benefits, DE Healthy Child Program, or other sources of periodic income. (Copies of Personal Income Tax Return do not document income. If parent/guardian operates their own business, they must supply a business license with entire current Business Tax Return.) Applicants should provide copies, which can be left with your application file, of all the required documents listed on this page to ensure you will have a completed application. Incomplete applications will not be considered for employment with Summer Youth Employment Program. For questions please call 302-395-5600.

Youth participants must be 14 to 20 years of age. Working permits and parental/guardian consent forms will be required for youth 17 years of age and younger. Participants will receive the minimum hourly wage of $10.10 per hour. All parts of this application must be completely filled out in order for it to be considered for employment. YOUTH APPLICATION FOR STATE SUMMER YOUTH EMPLOYMENT PROGRAM Name: Last First, M.I. Birth Date: Age: S.S. # Address: City State Zip Code County Mailing Address (if different from above): Home Phone: Cell Phone: I am a member of a Two-Parent Family: Single-Parent Family Total Family Members in Household: Family Income Income Source Income Amt. Parent(s)/Guardian Name (s) Relationship Employer Gross Annual Income Total Family Income: PROOF OF PARENTAL/GUARDIAN INCOME (W-2 FORM) MUST DOCUMENT THE ABOVE

Education Last Grade Completed: Last School Attended: High School Graduate? Yes No GED? Yes No College Number of Years Completed: Are you currently attending any education or training classes? School or Training Agency Location Work History List all work including part-time and volunteer work. (You may add additional pages.) Current or Most Recent Employer Name: Address: Job Title and Duties: Work Hours per Week: Starting Date: Hourly Wage: Ending Date: Reason for Leaving: Additional Employers Name: Address: Job Title and Duties: Work Hours per Week: Starting Date: Hourly Wage: Ending Date: Reason for Leaving:

PLEASE READ CAREFULLY: Your application will not be accepted if this section is not completed: I certify that the information provided is true to the best of my knowledge. I am aware that the information I have provided is subject to review and verification. I further understand that I must provide documents to support claims made in this application. I am also aware that I am subject to immediate termination from the State Summer Youth Employment Program if I am found ineligible after enrollment and may be prosecuted for fraud and/or perjury if I knowingly provided false information. I allow the release of this information for verification purposes, and understand that it will be used to determine eligibility. NAME: Signature of Applicant DATE: NAME: Signature of Parent or Guardian DATE: NAME: Signature of Grantee-Agency/Organization Representative DATE:

Name of Applicant: New Castle County Summer Youth Employment Program 2016 Applicant Supplemental Questionnaire Last First M.I. Email Address: 1. Are you, or have you ever been employed by NCC SYEP? Yes No 2. If previously employed by NCC SYEP, please indicate the worksites you worked, and dates of employment. 3. State briefly any accomplishments, hobbies, skills, scholastic honors, interests, or experiences you would like noted.

4. What mode of transportation would you most likely utilize to get to and from work? Personal Vehicle Drop off/pick-up Public Transportation Bicycle Walk Other 5. What is the maximum distance you would be able to travel to a possible work site? (Check all that apply) 1 mile or less 2-4 miles 5-7 miles 7-10 miles 10 miles or more 6. While the New Castle County Summer Youth Employment Program may not be able to assign you specifically to a worksite within your industry of interest, please indicate your top three choices from the options below. Office/Administrative Support Theater/Performance Technology Public Works Maintenance Library Aide Custodian/Maintenance Outdoor recreation/parks Senior Assistance Youth Assistance & Mentorship Data Entry Park Aide Farm/Barn Maintenance Parks Conservation Landscaping/Grounds Maintenance Customer Service Pool Supervision/Maintenance 1 st Choice: 2 nd Choice: 3 rd Choice:

7. Please describe your career goal and how you will achieve it? 8. Please identify any commitments with dates that you have during the summer that should be taken into consideration when developing your work schedule (i.e. Firefly, vacation, college, sports, extracurricular activities for schools, etc.)

ELIGIBILITY TABLES Please use and follow the below tables when selecting participants. TABLE A The authorizing legislation for the program requires that preference for employment be given to youth who are members of households whose income does not exceed 200% of the household poverty. *This table is subject to change. Family Size 200% Level* 1 $23,340.00 2 $31,460.00 3 $39,580.00 4 $47,700.00 5 $55,820.00 6 $63,940.00 7 $72,060.00 8 $80,180.00 9 $88,300.00 10 $96,420.00 TABLE B Total # of Minimum # Maximum # Youth hired of disadvantaged of non-disadvantaged With SSYEP $ Youth Youth 1 1 0 2 1 1 3 2 1 4 3 1 5 4 1 6 4 2 7 5 2 8 6 2