Summer Youth Program Initial Information Form
To be eligible for the Summer Youth Employment and Training Program, you must:
· Be between 14-24 years old as of July 1, 2020
· Live in the Eastern Connecticut Region
· Be eligible to work in the United States
 
You may also have to meet one of the following income requirements:
· Be eligible for free or reduced lunch; or
· Be receiving food stamps or cash assistance from the state; or
· Have an active Department of Children and Families (DCF) case; or
· Be a member of a family with income below 185% of the Federal Poverty Level
 
Please be aware that funding for the program has not yet been finalized.
 
For more information about the 2020 summer program please fill in the pre-application below.

As a public, non-profit, Regional Educational Service Center, and Employment and Training Provider, EASTCONN is bound by Connecticut state student-privacy laws, which prohibit the use of student information for any purpose other than the student intends, and the Personal Identity Information Policy contained within the Connecticut Department of Labor Workforce Innovation Opportunity Act Manual. All information collected here, both from students and non-students, will be used solely for the purpose of enrollment in the 2020 EASTCONN Summer Youth Employment and Training Program, and will not be shared or used for any other purpose.
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Email *
I acknowledge that I have read this statement and I give my permission to provide Personal Identifiable Information below. *
Required
Student First Name *
Student Last Name *
Phone Number
Student's Resident Town *
School Attended (if applicable)
Grade Level if in School
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How did you hear about the Summer Youth Employment and Training Program?
A copy of your responses will be emailed to the address you provided.
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