Kollab Youth Application Form

To apply to Kollab Youth's Winter Session, all applicants must complete the form below. The deadline to apply is Monday, January 22, 2024 by 5:00 PM.

Once we have received your application, the next steps will be sent directly to the applicant's email.

Requirements to apply:

Applicants must be between the ages of 14 to 19 years old.
Applicants must have a strong commitment to the program schedule.
New applicants must complete a one-on-one interview with a Kollab staff member. Returning members are not required to interview.
New applicants must complete a personal statement essay and submit it in the application form.
All applicants must complete a parent consent form if under 18 years old. The parent consent form is available on Kollab Youth's registration page, scroll down to find it.
Kollab Youth provides low income underserved youth an exceptional program in workforce development within a nurturing environment, empowering teens to develop their potential, pursue their education and careers while strengthening their communities and it is free.

About Kollab Youth's program:

Winter Session Timeline: February 5th to April 5th, 2024. (9 Weeks)
Virtual classes are every Wednesday and Thursday at 4:30 PM to 5:30 PM. Attendance is required.
Returning Kollab members, who are over 16 years old, have the option to be paired up with a professional mentor who will support them through the program. Find more about mentorship here.
Youth over 15 years old will be enrolled as pre-apprentices, where they can obtain paid job opportunities.
Youth can win various prizes such as tablets, gift cards, school supplies, etc.

Questions? Email: schaparro@kollabyouth.org

For more information, visit: kollabyouth.org. To stay connected with Kollab Youth News, click here to subscribe to our e-newsletter.

Question Title

* 1. Please fill out the contact information of the applicant.

Youth FIRST Name

Youth LAST Name

Address

City/Town

State/Province

ZIP/Postal Code

Youth's Personal Email Address (Non-school email)

Youth's Phone Number

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* 2. Applicant's Birthdate (Month/Day/Year)

Select Birthdate

Date

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* 3. Applicant's Gender

Female

Male

Other (specify)

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* 4. What race/ethnicity best describes the applicant? (Please choose only one.)

American Indian or Alaskan Native

Asian / Pacific Islander

Black or African American

Hispanic

White / Caucasian

Multiple ethnicity / Other (please specify)

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* 5. What grade is the applicant?

9th grade

10th grade

11th grade

12th grade

Fifth year / Other

Other (please specify)

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* 6. Which high school or college is the applicant attending?

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* 7. What is the applicant's affiliation? (Name of your Boys & Girls Club, Nonprofit, School District)

Antelope Valley Boys and Girls Club

Boys & Girls Clubs of the Los Angeles Harbor

Santa Clarita Valley Boys & Girls Club

Boys & Girls Club of San Fernando Valley

Boys & Girls Club of Burbank and Greater East Valley

West Valley Boys & Girls Club

Boys & Girls Club Hollywood

Variety Boys & Girls Club

Non-Club member

Other (please specify)

Question Title

* 8. Name and email of your parent/guardian if you are under 18 years old. Parents/Guardians, stay connected with Kollab Youth News, click here to subscribe to our e-newsletter. If you are 18 and over, write "N/A".

FIRST Name *

LAST Name

Email Address *

Phone Number *

Question Title

* 9. If you are a member of a Boys & Girls Club, School District, or other Nonprofit, please provide the name and email of your staff member contact. If you do not have a staff contact, write "N/A".

FIRST Name *

LAST Name

Email Address *

Phone Number *

Question Title

* 10. FOR 15 YEARS AND OLDER: I acknowledge I have to give my Social Security number (SSN) to Sari if I would like to be registered as a pre-apprentice. (If you have any questions please reach out to schaparro@kollabyouth.org)

I acknowledge

I do not have a Social Security Number

I am under 15 years old

Question Title

* 11. Is the applicant a Veteran?

Yes

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* 12. Does your family receive CalWORKs or/and CalFresh? Check all that apply.

CalWORKS

CalFresh

Reduced/Free Lunch

None

Other (please specify)

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* 13. What was your total family income before taxes?

Less than $30,000

$30,000 to $40,000

$40,000 to $50,000

$50,000 to $60,000

$60,000 to $70,000

$70,000 to $80,000

$80,000 to $90,000

$90,000 to $100,000

$100,000 or more

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* 14. How many people, including yourself, currently live in your household?

Question Title

* 15. Please check all that apply to Kollab Youth teen's status.

Homeless

Foster Youth

Re-entry (probation)

None of the above

Question Title

* 16. What social media platform do you use? Check all that apply. And make sure to follow us on our platforms: Instagram | Twitter | LinkedIn | Facebook

Tik Tok

Instagram

Twitter

Facebook

Snapchat

Other (please specify)

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* 17. Please share your social media handles and which platforms.

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* 18. Do you have a smart device (Tablet, Desktop or Laptop) and wi-fi?

Yes, I have both

Only wifi

Only Smart Device

None of the above

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* 19. Share your career industry interest...

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* 20. FOR 16+ ONLY: Kollab applicants who are 16 years old and older have the option to be assigned a mentor who will increase their opportunities for success. If you opt-in, you will need to include in your essay why you would like a mentor and attend a separate "Mentee Workshop."

Opt-out; I would not like a mentor at this moment.

Opt-in; I would like a mentor and I will include in my essay why I want a mentor.

I am under 16 years old.

Question Title

* 21. Kollab Youth requires new applicants to submit an essay as part of the application process. Please upload your essay here.

Returning applicants are not required to submit an essay, please upload a blank form.

For this essay, please write a personal statement on why you would like to join the Kollab Youth workforce development program. Please cite specific points that inspired you to join, why Kollab instead of other programs, what is driving you to this program, and what you intend to apply and why. If you have any questions, please let Sari Chaparro know at schaparro@kollabyouth.org.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Question Title

* 22. You MUST upload the parent consent form if you are under 18 years old. You can find the parent consent form on Kollab Youth's registration page, scroll down to find it. If you are having trouble uploading the form, please email it to Sari Chaparro at schaparro@kollabyouth.org.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Question Title

* 23. How did you hear about Kollab Youth?

Instagram

Twitter

Facebook

Friend/Family

Boys & Girls Club

Other (please specify)

Kollab Youth Application Form

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* 1. Please fill out the contact information of the applicant.

Question Title

* 2. Applicant's Birthdate (Month/Day/Year)

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* 3. Applicant's Gender

Question Title

* 4. What race/ethnicity best describes the applicant? (Please choose only one.)

Question Title

* 5. What grade is the applicant?

Question Title

* 6. Which high school or college is the applicant attending?

Question Title

* 7. What is the applicant's affiliation? (Name of your Boys & Girls Club, Nonprofit, School District)

Question Title

* 8. Name and email of your parent/guardian if you are under 18 years old. Parents/Guardians, stay connected with Kollab Youth News, click here to subscribe to our e-newsletter. If you are 18 and over, write "N/A".

Question Title

* 9. If you are a member of a Boys & Girls Club, School District, or other Nonprofit, please provide the name and email of your staff member contact. If you do not have a staff contact, write "N/A".

Question Title

* 10. FOR 15 YEARS AND OLDER: I acknowledge I have to give my Social Security number (SSN) to Sari if I would like to be registered as a pre-apprentice. (If you have any questions please reach out to schaparro@kollabyouth.org)

Question Title

* 11. Is the applicant a Veteran?

Question Title

* 12. Does your family receive CalWORKs or/and CalFresh? Check all that apply.

Question Title

* 13. What was your total family income before taxes?

Question Title

* 14. How many people, including yourself, currently live in your household?

Question Title

* 15. Please check all that apply to Kollab Youth teen's status.

Question Title

* 16. What social media platform do you use? Check all that apply. And make sure to follow us on our platforms: Instagram | Twitter | LinkedIn | Facebook

Question Title

* 17. Please share your social media handles and which platforms.

Question Title

* 18. Do you have a smart device (Tablet, Desktop or Laptop) and wi-fi?

Question Title

* 19. Share your career industry interest...

Question Title

* 20. FOR 16+ ONLY: Kollab applicants who are 16 years old and older have the option to be assigned a mentor who will increase their opportunities for success. If you opt-in, you will need to include in your essay why you would like a mentor and attend a separate "Mentee Workshop."

Question Title

* 21. Kollab Youth requires new applicants to submit an essay as part of the application process. Please upload your essay here. Returning applicants are not required to submit an essay, please upload a blank form.

Question Title

* 22. You MUST upload the parent consent form if you are under 18 years old. You can find the parent consent form on Kollab Youth's registration page, scroll down to find it. If you are having trouble uploading the form, please email it to Sari Chaparro at schaparro@kollabyouth.org.

Question Title

* 23. How did you hear about Kollab Youth?

* 21. Kollab Youth requires new applicants to submit an essay as part of the application process. Please upload your essay here.

Returning applicants are not required to submit an essay, please upload a blank form.