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2. Mayor's Youth Workforce Experience
   2021 Summer Cohort

   The application period for the 2021 Summer Cohort will close on Sunday, May 9th at 11:59 p.m. The application will remain open for year-round opportunities, and we encourage you to apply to remain updated.

   
   

   “The Mayor's Youth Workforce Experience creates a pathway to success by providing young adults with a chance to discover interests, build skills, and explore careers through experiences that can serve as the foundation for educational and professional success.” — Mayor-President Sharon Weston Broome

   
   

   Thank you so much for your interest in participating in the 2021 Mayor’s Youth Workforce Experience, an initiative of the Office of Mayor-President Sharon Weston Broome. Scholars accepted to the summer cohort will participate in an 8-week career preparation and exploration experience. Applicants not selected for the summer cohort will have access to other resources through the Mayor’s Youth Workforce Experience.

   
   

   In order to continue to protect and serve our scholars and staff, the 2021 MYWE summer cohort will participate through virtual programming. Programming, provided in partnership with Big Buddy, will lead scholars through four key pillars:

   
   

   • Mentor Support
   • Training and Enrichment
   • Civic Responsibility
   • Social Emotional Learning Skills
   
   

   There is limited space in the summer cohort, so please read all the requirements carefully and fully complete the application. All requirements must be met to be considered for participation in the program.

4. Applicant/Scholar's Information
6. Scholar's First Name*
7. Last Name*
9. Birth Date:*
   Birth Date:
10. Age*
11. Gender*

    1. Male
    2. Female
12. Application Code
14. Address*
15. City
16. State
17. ZIP Code*
19. Email Address:*
20. Are you currently enrolled in school?

    1. Yes
    2. No
21. School Name:
    If yes, enter your school's name.
23. Have you participated in this summer employment program before?

    1. Yes
    2. No
24. Are you currently employed?*

    1. Yes
    2. No
25. Have you ever had a job?

    1. Yes
    2. No
27. Ethnicity:

    1. African-American
    2. Asian
    3. Hispanic
    4. Native American
    5. Caucasian
    6. Other
28. Highest Level of Education:*

    1. Still in high school
    2. Less than high school
    3. High school diploma/GED
    4. Technical School/College/University
29. Your grade during 2020/2021 school year (if still in school):

    1. 6th
    2. 7th
    3. 8th
    4. 9th
    5. 10th
    6. 11th
    7. 12th
30. Adult T-Shirt Size:

    1. Small
    2. Medium
    3. Large
    4. XL
    5. 2XL
    6. 3XL
32. Does applicant qualify for Healthy Louisiana (Medicaid & LA CHIP)?*

    1. No
    2. Yes
33. If yes, please select a provider:

    1. Aetna Better Health of Louisiana
    2. Healthy Blue
    3. AmeriHealth Caritas
    4. Louisiana, Inc.
    5. Louisiana Healthcare Connections
    6. United Healthcare Community Plan
37. Household and Parent/Guardian Information
39. Please indicate your household's total income:

    1. Less than $11,880
    2. $11,881 - $16,020
    3. $16,021 - $20,160
    4. $20,161 - $24,440
    5. $24,441 - $28,440
    6. $28,441 - $32,580
    7. $32,581 - $36,730
    8. $32,581 - $36,730
    9. $36,731 - $40,890
    10. More than $40,891
40. With whom does the applicant live?*

    (Select all that apply.)

    1. Mother
    2. Father
    3. Stepmother
    4. Stepfather
    5. Grandparent(s)
    6. Foster Parent(s)
    7. Other
41. Occupancy
    Please tell us your relationship to the head of your household.
43. How many children live in your household?*
    List the number of residents under 18.
44. How many adults live in your household?*
    List the number of residents aged 18 and older.
46. Parent/Guardian Information:
48. Name*
49. Relationship to applicant:*
51. Email address:
53. Employer:
55. Work Phone:
56. Cell Phone:
57. Home Phone:
59. Emergency Contact's name:
60. Contact's phone:
64. Terms & Agreements
66. Scholar Interest Survey

    Select all areas of interest:

    1. Agriculture
    2. Architecture
    3. Business
    4. Law
    5. Child Development
    6. Education
    7. Engineering
    8. Theater/Film
    9. Information Technology
    10. Community Revitalization
    11. Other
67. Motivational Statement*
    (Please tell us what you are hoping to gain from this opportunity.)
69. Please tell us what field you're interested in:
71. Applicant Agreement

    Please read and check off each statement.

    1. I certify the information is true and complete to the best of my knowledge.
    2. I am aware incorrect information or false information may result in termination from this program.
    3. I authorize the MYWE Program to examine and collect all personal records for the purpose of determining eligibility in the Summer Internship and evaluating the program.
    4. I am aware I must be able to commit to the entirety of the program (Including summer school, vacations, practices, employment.)
    5. I understand transportation to and from program activities are primarily my responsibility to arrange.
    6. I understand that I am required to complete and participate in all training sessions and projects.
    7. I understand my stipend payments will be dependent on my attendance, weekly evaluations, completion of tasks, certification courses, and active participation in the program.
    8. I am willing to participate in the MYWE Internship to the best of my ability with a positive attitude and an open mind.
73. Applicant's Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
74. Please read and check each statement:*

    1. By signing this agreement, I agree to participate in the MYWE Internship to the best of my ability with a positive attitude and an open mind.
    2. I, the [applicant, requestor, etc.] for this [type of form], warrant the truthfulness of the information provided in this application.
    3. I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
76. Applicant's Electronic Signature*
77. Date*
    Date
79. Parent/Guardian's Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
80. Please read and check each statement:

    1. I, the [applicant, requestor, etc.] for this [type of form], warrant the truthfulness of the information provided in this application.
    2. I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
82. Parent/Guardian's Electronic Signature*
83. Date*
    Date
Leave This Blank:


85. 1. Receive an email copy of this form.
86. Email address

    This field is not part of the form submission.

87. Submit

* indicates a required field