forms and applications

Important Forms

Instructions: Please fill out the Peer Education Application or download the form and email it to stacey.richards@ppcwny.org.

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“In Control of You”
a youth development program

This employment opportunity will provide necessary skills to thrive in high school and into adulthood. Every day you will build your leadership abilities, executive function, self-advocacy, and social skills while making deep connections and building lifelong memories.

Topics include:
– Financial literacy
– Mental Wellness
– Reproductive health and relationships
– Cooking
– Career readiness
– Social etiquette

*All positions at In Control require proof of completed COVID-19 vaccine series.

Name (First and Last)

Are you between the ages 14 and 19?

Email

Street Address

Zip Code

Primary Phone

Whose number is this?

Secondary Phone

Whose number is this?

Are you legally authorized to work in the United States? Yes or No

Do you have a work permit?

Do you have any work experience? If so, what work experience do you have?

How did you hear about this position?

Are you a member of any clubs, groups, teams, etc.

Which school do you attend?

What grade are you in?

Do you have reliable transportation? Do you anticipate any barriers to transportation? If so, how can we help?

Why do you want to work for our program?

Provide an example of a time you demonstrated leadership abilities.

Please attach any resume , certificate , etc