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Mayor’s Summer Work Experience Program

  1. Directions: Please complete the application below in full. If you are helping an applicant complete this form all of the information entered below should be about the applicant. The electronic signature must be the applicant’s and it represents they attest to the information and intention to apply.

  2. NOTE: The name on your application must match the name listed on your Social Security Card. Your original Social Security card will be REQUIRED upon hire.

  3. APPLICANT'S PERSONAL INFORMATION: (REQUIRED)

  4. EDUCATION: (REQUIRED)

  5. Check Highest Grade Completed:*

  6. Graduated:*

  7. MOST RECENT EMPLOYMENT/VOLUNTEER EXPERIENCE: (REQUIRED – Type N/A if you do not have prior experience)

  8. EMERGENCY CONTACT INFORMATION: (REQUIRED)

  9. Parent/Guardian #1

  10. Parent/Guardian #2

  11. ADDITIONAL QUESTIONS FOR MAYOR’S SUMMER WORK EXPERIENCE: (REQUIRED)

  12. 1. Are you a resident of Shelby County?*

  13. 2. Are you between the ages of 16-24 by June 1, 2020 and will not reach age 25 before the completion of the program? *

  14. 3. Are you available to work EVERY WEEK DAY from June 1, 2020 through July 24, 2020?*

  15. 4. Are you available to work during the hours of 8 a.m. and 4:30 p.m.?*

  16. Leave This Blank:

  17. This field is not part of the form submission.