Y2Y: TAY Peer Certificate & Employment Program

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Thank you for your interest in Youth 2 Youth: TAY Peer Certificate & Employment Program! Youth 2 Youth TAY Peer Certificate is a competitive 16-week training program that prepares Transitional Age Youth (TAY) with basic counseling skills for entry-level employment in the behavioral health field. Please read and complete the entire application. If you have any questions, please contact Christian Ribeiro, TAY Program Coordinator at christianribeiro@hire-ability.org or (415) 530-9080.

Application Requirements: In order to participate, you must meet these requirements.

- Be between the ages of 18-24
*17 year olds are also eligible if turning 18 by graduation of this program
- Be a resident of San Francisco
- Are interested in helping others in a behavioral health setting
-Be able to commit to a 16-week program the meets twice per week

Program Perks: What will YOU get out of this program?

- Chance to earn a certificate that will lead to entry-level employment in the mental health field.
- Receive a stipend upon completion of the Certificate Program.
- Chance to explore the behavioral health field in San Francisco.
- Employment Program immediately following successful certification that will help you find an internship as a peer counselor.
- Gain connections in the field to people who have similar interests and passions.

Email *

First & Last name *

Date of birth *

SSN *

Cell Phone *

Street Address *

City & Zip Code *

Email *

Best way to reach you? *

Call

Text

How did you hear about us?

Please list all of the languages (other than English) you speak well enough to potentially provide services in:

Program Requirements

In order to participate, you must meet these requirements.

(*Due to covid-19 restrictions, workshops will be focused on virtual learning with in person workshops in accordance to shelter in place guidelines.)

Are you currently a San Francisco resident? *

Yes

Are you able and willing to commit to the 16-week long program? *

Yes

Are you available to attend twice weekly virtual AND in person workshops for 2-3 hours between 3-6pm on Tuesdays and Fridays? * *

Yes

Have you or a family member ever had lived experiences with mental health challenges (e.g. talking to a counselor/therapist, etc.)?

Yes

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References

You must have two references. One reference may be a therapist/counselor. The other should be an adult who is NOT a family member—such as a teacher, school counselor, or coach.

Reference 1: Name, phone number, email, relationship: *

Reference 2: Name, phone number, email, relationship: *

Getting to Know You Questions

What inspired you to apply for this program? What do you hope to gain by participating in this program? *

If you could learn more about a particular topic in the mental health field, what would it be? Why? *

What are your hobbies and interests? Do you participate in any extracurricular activities or volunteer work? *

What do you do when you are feeling stressed? What are some of your favorite self-care activities? *

What does wellness and recovery mean to you? How have you been able to work through and take care of yourself throughout difficult life experiences? *

What is an area of growth that you would like to improve in? (e.g. “I want to get better at public speaking.” Or “I would like to practice my interview skills”) *

Are there any other life commitments you're engaged in (e.g. work, school, etc.)? *

Application check list:

☐ Contact information, full SSN, and other information required on the first page of the application
☐ Acknowledgement of meeting the program requirements
☐ “Getting to Know You” questions (typed or in blue or black ink, please write clearly)
☐ Two references
☐ Parent signature if you are under 18
☐ Proof of residency (copy of driver’s license or California State ID preferred).

Your proof of residency must include your San Francisco address listed. Please attach your proof of residency along with your application in the same email. Proof of residency may consist of most any form or letter that includes your name and address.

Electronic Signature: (please read the paragraph then sign below).

I certify that I have not purposely withheld any information that might negatively affect my chances for acceptance. The answers given by me are true and correct to the best of my knowledge and ability.

I permit RAMS to contact the references I have provided regarding the Youth2Youth TAY Peer Certificate Program. I authorize the references I have listed to provide any information about my related experiences without giving me prior notice of such disclosure.

Applicant Signature *

Date *

YYYY

I give permission for my child to participate in Youth 2 Youth. Parent/Guardian e-Signature (for applicants under 18): *

Please email, fax, or submit your application in person no later than the upcoming deadlines listed on the flyer/brochure. Hire-Ability Youth 2 Youth 1234 Indiana St. San Francisco, CA 94107. Email: christianribeiro@hire-ability.org Phone: (415) 530-9080

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