Welcome to the Urban Corps of San Diego County Job Training Program Interest Form! - An Equal Opportunity and Section 3 Employer Learning, Earning & Conserving Since 1989!

Urban Corps programs and activities shall be free from discrimination based on gender, sex, race, color, religion, ancestry, national origin, ethnic group identification, marital or parental status, physical or mental disability, sexual orientation or the perception of one or more of such characteristics.

APPLICANT INFORMATION:

Please fill out all questions to the best of your ability.
If you don't have all the requested information, please at a minimum make sure to leave a working phone number where we can contact you

CORPS SITE / LOCATION:
1.
Are you interested in the San Diego or the Escondido location?:
NAME / PHONE / ADDRESS etc.:
2.
First Name:*
 
Last Name(s):*
 
3.
Date of Birth:*
 
Current Age:
4.
Street Address:
Apt #:
5.
City:*
 
State:*
Zip:
6.
Primary Phone #:*
 
Phone Type:
7.
Email Address:*
   
REINSTATEMENT / REFERRAL SOURCE:
8.
Reinstatement Application:*
Please fill out the following Reinstatement questionaire (skip if not enabled):

REINSTATEMENT QUESTIONAIRE (Required):

8a.
Why did you leave the Urban Corps last time:*
8b.
Why do you want to come back?:*
8c.
What will you do differently to ensure success in the program?:*
9. 
How did you hear about us? How were you referred?

Please make a selection from both dropdowns when the first selection is one of Online/Web, Advertisement, Community Organization or Law Enforcement!:*
 
 
9b. 
Have you seen any Urban Corps advertisements recently?:







Other:
9c. 
If referred by a Former/Current Corpsmember please specify:
9d. 
Case Manager (If referred from other organization):
Case Manager Phone:
BACKGROUND INFORMATION:
10.
Are you legally eligible to work in the US?:
11.
Do you have a valid California Driver's license?:
EDUCATION STATUS:
12.
Do you have a High School Diploma?:
13.
Do you have GED/Equivalency:
14.
Are you currently enrolled in any school:
If Yes, Which School?:
15.
Highest Grade level completed: