Green Job Corps Application Page 2
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4Green Job Corps Application
(updated 11-24-09)
TELL US YOUR WORK HISTORY:
How many weeks of the last 3
Are you presently self-
Do you consider yourself
Are you Legally Eligible to Work in the U.S.?
months have you worked?
employed?
under-employed?
Decline to State
Yes
Yes
Yes
Unsure
No
No
No
Are you changing careers?
Are you a homemaker entering/re-entering the workforce?
No
Yes
Yes
No
Your current or most recent employment:
To (mm/dd/yy)
Full Time
Temporary
Job Title
From (mm/dd/yy)
Part Time
Seasonal
Wage: $______/hr
Description of Duties:
Check here if this is the highest wage
you've earned in the last 6 months
Supervisor
Employer
Supervisor
Telephone
Name
Still at this job?
If not, what is you reason for leaving?
Dismissed
Other
Yes
No
Moved
Found New Job
Temporary
Quit
Not Enough Pay
Laid Off
Your next most recent employment:
Temporary
To (mm/dd/yy)
Full Time
Job Title
From (mm/dd/yy)
Seasonal
Part Time
Wage: $______/hr
Description of Duties:
Check here if this is the highest wage
you've earned in the last 6 months
Supervisor
Employer
Supervisor
Name
Telephone
Still at this job?
If not, what is you reason for leaving?
Dismissed
Other
Yes
No
Moved
Found New Job
Temporary
Quit
Not Enough Pay
Laid Off
Other employment services received-- Please list any other workforce or job training programs in which you've participated:
Program Preferences
The semester long course is offered at 3 City College Campus locations at different times. Please check all of the campus options you
would be able to attend. Classes start January 19, 2010.
MISSION CAMPUS at 1125 Valencia Street, San Francisco: Monday- Thursday morning classes
SOUTHEAST CAMPUS at 1800 Oakdale Avenue, San Francisco: Monday- Thursday evening classes
at 940 Filbert Street, San Francisco: Monday-Thursday evening classe
CHINATOWN CAMPUS
The semester long program prepares students for success in City College's technical certification programs. Which of
these technical certification programs interest you? (check all that apply)
? Green construction
Solar panel installation
Hybrid/electric vehicle service
Environmental monitoring
? Energy efficiency
Green auto body
Environmental horticulture
Green business
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Parent category: Business