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4MyCiTy U! - Job Training and Mentoring Program.
Profile Form
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1.
What is your First Name?
(Required.)
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2.
What is your Last Name?
(Required.)
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3.
What is your Phone Number? (xxxxxxxxxx)
(Required.)
4.
What is your Email Address? (_________@______.___)
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5.
What is your Home Address ( You Must live within a 10 Mile radius of our warehouse located at 1133 Wilso Drive Baltimore MD 21223 to qualify for our program )
(Required.)
Address
City/Town
State/Province
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code
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6.
How did you hear about the 4MyCiTy U! - Job Training and Mentoring Program?
(Required.)
Social Media - Instagram/Facebook/Twitter/TikTok
Our Website
Word Of Mouth
Other Youth program referral
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7.
What is your current Household Income level?
(Required.)
Under $15,000
Between $15,000 and $29,999
Between $30,000 and $49,999
Above $50,000
Not currently working
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8.
Which ethnicity best describes you?
(Required.)
White or Caucasian
Black or African American
Hispanic or Latino
Asian or Asian American
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
Another race
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9.
How many members are there in your household?
(Required.)
1-3
4-7
8 or more
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10.
What is your age range?
(Required.)
16 - 18
19 - 21
22 - 26
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11.
What is your current means of transportation?
(Required.)
Walk
Personal Vehicle
Public transportation ( Bus, train)
Paid transportation ( Uber, Lyft, Taxi)
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12.
I understand that 4MyCiTy U! - Job Training and Mentoring Program is an at will program administered by the 4MyCiTy Inc. leadership team. This program is solely based on funding availability and can be terminated at anytime with little or no advanced notice. All participants in this program will be paid a base hourly rate of $15.00 per hour and work no more than 20 hours per week at any given time. This program is a 5 Week training Program, with participants expected to complete a minimum of 80 working hours to be considered for graduation.
(Required.)
I Understand
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13.
I agree and Understand that 4MyCiTy Inc. Is a nonprofit organization and is doing this service Free of charge to me and or my family on a voluntary basis. This program is not a guaranteed program and can end at anytime without notice. 4MyCiTy does not guarantee future employment through this program for any participants. 4MyCiTy leadership will work with participants of this program to successfully achieve the overall goals outlined, which is to provide a path to future employment opportunities with some of our selected community business partners.
(Required.)
Agree
Type your name as acknowledgement