3039 East 91st Street Chicago, IL | Phone: 773.734.9181 | Fax: 773.734.9221
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South Chicago Neighborhood Network – U.N.I.T.Y SQUAD Application (United Network influencing the transformation of Youth)
It is the policy of Claretian Associates to seek and employ the best qualified personnel in all of its operations and to provide equal opportunity for the advancement of employees, including upgrading, promotions, and training; and to administer these activities in a manner which will not discriminate against any person because of race, color, religion, national origin, sex,
ancestry, citizenship, marital status, sexual orientation, parental status, source of income, age
disability, or any other legally protected category.
All applicants 14 - 17 years of age.
PLEASE FILL OUT THE ENTIRE FORM BELOW & CLICK SUBMIT WHEN DONE
*
Indicates required field
Are you available through the academic school year of 2021- 2022?
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Yes
No
Identification
Name
*
First
Last
Age
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Email Address
*
Phone Number
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Birth Date
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General Information
Only U.S. Citizens or aliens who have a legal right to work in the U.S. are eligible for employment. Can you, upon employment, provide genuine documentation establishing your identity and eligibility to be legally employed in the United States?
*
Yes
No
Education
High School (Name & Location)
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Elementary School (Name &Location)
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Year in High School?
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If you speak a language other than English, which language(s) is it?
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Parent/ Guardian Contact information
Name
*
First
Last
Phone Number
*
Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
EMERGENCY CONTACT
Name
*
First
Last
Phone Number
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Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Please list any medical issues or medications that your child may have:
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References
(Please list two Teachers or Counselors we may contact for references)
Reference 1
Name
*
First
Last
Relationship
*
Phone Number
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Length of Relationship
*
Reference 2
Name
*
First
Last
Relationship
*
Phone Number
*
Length of the Relationshop
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Questions
How did you hear about the U.N.I.T.Y SQUAD?
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What type of impact are you trying to make within your community?
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Why do you feel like you will be the best candidate for the U.N.I.T.Y SQUAD?
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What strengths will you bring to the U.N.I.T.Y SQUAD?
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If you could bring any program or event to the U.N.I.T.Y SQUAD what would it be?
*
Acknowledgement
Please read carefully before signing
.I affirm that all statements and answers I have given are true and correct to the best of my knowledge and that if employed any false, misleading, or otherwise incorrect statements made on this application or any other documents provided during the application process may be grounds for immediate discharge.
I authorize Claretian Associates and its parent company (Claretian Missionaries Service Corporation) to conduct any necessary and reasonable investigations with respect to my application, and release the company, my former employers, and professional references from any liability from damage caused by giving and receiving information or opinions as to my employment or character.
I understand that neither the information provided in this application nor my hiring by Claretian Associates constitutes an employment contract. I further understand that any employment relationship with Claretian Associates is of an “at will” nature, and may be terminated by the company or myself at any time for any reason or no reason at all, with or without prior notice.
Student E-signature
*
Date
*
Parent E-signature
*
Date
*
Submit
If you have any questions please contact,
Tiarra Owens, Program Manager
773-734-9181 Ext. 2030
tiarrao@claretianassociates.org
