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Youth Health Educator Job Application
Home
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This is a paid job starting at $7.25/hour, working 4-6 hours/week during school and in the office after school
You get training on sexual health and how to educate others
You do lunchroom presentations at your school every week
You distribute condoms to your peers at your school every week
You have the opportunity to be promoted (with raise) and take on more responsibilities at school
Applicant Information
Full Name
*
Grade (Now)
Select
9th
10th
11th
12th
School
Address (include Apt #)
Zip
Ward #
- None -
Ward 1
Ward 2
Ward 3
Ward 4
Ward 5
Phone 1
*
Phone 2
Email Address
*
Date of birth
*
Year
Year
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Month
Month
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Day
Day
1
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Age
*
I am
*
Others
Female
Male
Gender_others
*
GPA
*
I missed more than 15 days of school last year
*
No
Yes
I have had experience with Foster Care:
*
Yes, I was previously in Foster Care
Yes, I am currently in Foster Care
No
If YES, how long have you been in foster care?
*
Have you ever participated in SYEP?
*
NO
YES
Was this a SYEP position?
*
YES
NO
About You
I call myself (check all that apply):
*
African-American
Asian/Pacific Islander
European-American
Native American
Latinx/ Hispanic
Mixee/Bi-racial
Other:
myself_others
*
What would you like to contribute to your community (i.e. school, neighborhood, teen population, etc.)?
*
My goal in life is to...
*
How do you show respect for others?
*
Do you think young people's voices are important?
*
I want to be a youth health educator because...
*
Do you feel that sexuality education for teens is important? Why/why not?
*
What do you want to get out of this job?
*
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