YouthWorks Program Application

If you have questions, contact YWSL Director Jenn Sanchez at (801) 539-1590 ext. 122 or .
First Name(*)
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Middle Name
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Last Name(*)
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Date of Birth(*)
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Age(*)
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Gender(*)
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Email(*)
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Cell Phone(*)
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What language is spoken at home?(*)
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Parent/Guardian Name(*)
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Parent/Gurardian Employer Name(*)
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Parent/Guardian Phone(*)
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Parent/Guardian Email(*)
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Parent/Guardian Name (if additional)
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Parent/Gurardian Employer Name
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Parent/Guardian Phone
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Parent/Guardian Email
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To be employed with YWSL, you must be enrolled and attending school.
School(*)
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Grade(*)
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Who is your school tracker/counselor?(*)
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Counselor's Phone(*)
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Counselor's Email(*)
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Can you to be released from school by 12:30 p.m.?(*)
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Are you on work release?(*)
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Have you been involved in the court system?(*)
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If yes, explain:
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3rd District/JJS/DCFS case manager and/or other
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Case Manager/other Phone
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Case Manager/other Email
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When is your next court date?
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Do you have any fines/restitution/service hours?
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Have you ever worked before?(*)
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Company Name
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Dates when you worked there
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What type of work did you do?
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Supervisor’s Name
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Supervisor's Phone
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Emergency Contact (not parent/guardian)(*)
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Emergency Contact's Phone(*)
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How did you find out about YWSL?(*)
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