2023 Youth and Young Adult Employment Services (Y.E.S.) Program Sign-Up Form 
Welcome to Just Us 4 Youth and the Y.E.S. Program. Whether you are a student, young adult, or community member, feel free to join us at our employment sessions and workshops. 

Where to find us: 
     Tuesdays and Thursdays
     1 pm - 3 pm
     Pomona Public Library - Conference Room
     625 S. Garey Ave. Pomona, CA 91766

     Thursdays
     3:30 pm - 5:30 pm
     Pomona Public Library - Conference Room
     625 S. Garey Ave. Pomona, CA 91766

     Fridays
     3:30 pm - 5:30 pm
     Just Us 4 Youth - Main Office
     363 S. Park Ave. Pomona, CA 91766
     
     Monday to Friday
     Pomona Unified Middle and High Schools
     Lunch, Advisory, Free Period, and/or After School

For more information, please reach out to Tremale Ratcliffe, Y.E.S. Program Supervisor. 
Email: tremale@ju4y.org
Phone Number (text): (909)964-7789
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Participant's Full Name (First, Middle, Last) *
Participant's Date of Birth *
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Participant's Email *
Participant's Phone Number *
Address (Street Address, City, State, Zip Code) *
Pronouns (she/her/hers, he/him/his, they/them/theirs, ...)
School (If not applicable, type "N/A") *
Grade Level (If not applicable, type "N/A") *
Primary Language *
Are you a part of any Just Us 4 Youth programs? If so please list. (If not applicable, type "N/A") *
Parent/Guardian Name (First, Last) (If not applicable, type "N/A") *
Relation (If not applicable, type "N/A") *
Parent/Guardian Phone Number (If not applicable, type "N/A") *
How can the Y.E.S. Program best support you? *
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