Apply Now - Summer Jobs 253
APPLICANT INFORMATION – ALL INFORMATION MUST BE CLEARLY PRINTED.
Full Legal Name:
Date of birth Mo/Day/Yr:
Prefer not to say
Are you a citizen of the United States? YES
If no, are you legally authorized to work in the U.S.? YES
School (Tacoma Public School Required):
Expected Graduation Date (Mo, Yr):
*June, 2015 Graduates are not eligible.
Current Grade level:
Do you have a documented disability/IEP? YES
If yes, will you need accommodations on the work site? YES
Are you currently credit deficient? YES
History of disciplinary actions:
Have you ever reported to
Are you currently or have you ever
been in Foster Care? YES
SJ253 mandatory 20-hour orientation week: June 22 , 2015 – June 26th, 2015
SJ253 work calendar: July 1st, 2015 – August 14th, 2015
Please list the hours of your availability:
Comments concerning availability:
Do you have summer vacation plans? YES
Do you plan to attend summer school?
Are you presently employed? YES
If yes, when?:
If yes, where? ________________________________________________________
CERTIFICATIONS (EXAMPLES: WA FOOD HANDLER CARD, CPR, ETC.)
Do you have a valid WA Driver’s License? YES
Will you need assistance with transportation to work? YES
Do you live near a bus line? YES
SKILLS INVENTORY – PLEASE CHECK SKILLS RELATED TO YOUR ABILITY
Providing Customer Service
Basic Typing and/or Data Entry
Operating Phone Systems
Working with Children
Working in an Office Setting
Microsoft Office (Word, Excel)
Creating Arts and Crafts
Description of Job Duties:
Reason for Leaving:
Name of Emergency Contact:
Emergency Contact’s Address:
Relationship to you:
Emergency Contact’s Phone:
TEACHER REFERENCES (AT LEAST TWO) – REQUIRED
Teacher’s Printed Name
Teacher’s Email Address:
ESSAY PROMPT: Why is participating in the Summer Jobs 253 internship program important to you?
Instructions: As you respond to the essay prompt, think about who will read your statement and what you want them to
understand about you. While your personal statement is only one of many factors we consider when making our
acceptance decision, it helps provide context for the rest of your application.
Essays must be typed, double spaced, and a minimum of 650 words.
Please attach your completed essay to the Summer Jobs 253 student application.
I certify that the information provided is accurate and complete to the best of my knowledge. I understand that any falsification may cancel any terms, conditions or privileges of
employment. I understand submitting a completed application does not guarantee placement in the Summer Jobs 253 program and late applications will not be considered.
Signature of applicant:
Signature of parent/guardian:
Application Deadline: Tuesday, March 31st, 2015
Please return the completed Summer Jobs 253 application to your career counselor.
Late applications will not be considered.