Youth Development Program Application 2024 Youth Development Program Application ALL APPLICANTS MUST HAVE A MINIMUM OF A 2.50 GPA AND HAVE COMPLETED 9th GRADE OR ABOVE IN ORDER TO APPLYApplicant Last Name* First Name* Middle Initial* Application Date* DD slash MM slash YYYY Home Address* Street Address City State ZIP Applicant Cell Phone*Home Phone*Applicant Email Address* Date of Birth* MM slash DD slash YYYY Age* Gender* Male Female Applicant Race: (Please select one)* White/Caucasian Black/African American Native American Asian American Hispanic/Non-White Other Parent/Guardian Last Name* Parent/Guardian First Name* Parent/Guardian Email Address* Parent/Guardian Contact Phone Number*Please select one answer for the following (2) questions:Educational Status*(If not in high school please STOP. Do not complete this application) 9th-10th 10th-11th 11th-12th Do you have a minimum of 2.50 GPA or higher?*(If yes, please continue the application) Yes No Name of High School* Highest Grade Completed* GPA* The following information will help us determine eligibility for the POC Summer Youth Training and Employment ProgramHave you ever been arrested/pending charges?*(Background Checks Mandatory) Yes No Total family annual income (gross)*(Proof of income must be provided) Number of members in your household* Attach latest report card*Max. file size: 64 MB.Attach proof of income documentation*Max. file size: 64 MB.Release of Information I hereby authorize representatives of the POC Youth Development Program to obtain information concerning my household member’s income, ID and Security numbers for the purposes of determining eligibility. (ALL INFORMATION WILL REMAIN CONFIDENTIAL)APPLICANT SIGNATURE*DATE* MM slash DD slash YYYY PARENT/GUARDIAN SIGNATURE*Date* MM slash DD slash YYYY Completion of this application does not guarantee a position. Incomplete application will be discarded. If you have any questions, please call (727) 823-4101 ext. 115 or ext. 110 APPLICATION DEADLINE: February 7, 2024 VIRTUAL EDUCATION PROGRAM: FEB. 14 - MAY 1, 2024 SUMMER WORK PROGRAM DATES: JUNE 17 - JULY 26, 2024 RETURN THIS FORM, MOST RECENT REPORT CARD AND INCOME DOCUMENTATION TO: Pinellas Opportunity Council, Inc. 501 1st Avenue North, Suite 517 St. Petersburg, FL 33701 Home About Us Programs Locations News/Events Donate Contact Us FollowFollow