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Charleston County Human Services Commission Summer Youth Works! 2014 Application Name: ________________________________________________

Date: _____________________

Address:

Email:_______________________________________________________________________________

Phone: _____________________________ Alternative Phone: ______________________________ County where you live:

Berkeley

Charleston

Dorchester

Emergency Contact: ______________________________ Phone: ____________________________ How much work experience do you have?

None

1-6 months

One Year

1+ yrs

Have you applied for Summer Youth Works! in the past? _______________________ What high school or college are you now attending? _____________________________________________________________________________________ What is your status:

High School Junior

What is your current GPA: ______________

High School Senior

College Student

How many people live in your home: _________


In August 2014, what school will you be attending?

What is/will be your major in college?

Are you currently involved in any community service?

Yes

No

If yes, please give details:

Do you have membership with any national or local organization(s)?

Yes

No

If yes, give details:

Please share your personal goals for the next 3-5 years:

Please share how you plan to accomplish these goals:

a Project Pride program • 1069 King Street Charleston, SC 29403 • 843-724-6760 phone • 843-724-6787 fax


Summer Youth Works 2014 Application