2020 Summer Jobs & Professional Development Application
Worcester Community Action Council- Job & Education Center, (484 Main Street, Worcester, MA 01608 - Suite 203)
**Please note if you are under 18, we will need Parent Consent before interviewing.**

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Email *
Last Name *
First Name *
Age *
Telephone Number *
Address
Ethnicity
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Race
Name of High School Attending/Attending
Last Grade Completed
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Preference is given to Youth of the following:
Secondary Preference is given to the Youth of the following: *
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Are you authorized to work in the United States? *
 Job Interests (Please select 3 top interests) *
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Who Referred You?: *
How did you complete application?
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