NextGen Enrollment Form
Thank you for your interest in the NextGen Employment Services Program. We support individuals 18-24 years old who live in San Francisco that want a job and/or exposure to the workforce. This enrollment form takes 5-10 minutes to complete. Thank you for taking the time to fill it out! You will receive a "Welcome to NextGen" email within 2 days of submission. Our program is open enrollment so you can join anytime to receive our services. Contact us if you have any questions at hanextgen2020@gmail.com
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Are you currently attending school? *
What school are you attending?
Highest Level of Education *
Are you currently part of the San Francisco Unified School District (SFUSD)? *
Educational Attainment *
First Name *
Last Name *
Preferred Name (How we should address you if not the same as First Name)
Date of Birth (DOB) *
MM
/
DD
/
YYYY
Email Address *
Phone Number *
Housing Status *
Street Address *
Apt./Unit
City *
Zip Code *
Home Language *
SPECIFY Race/Ethnicity (e.g. Hispanic/Latino - Mexican/Mexican American) *
Gender Identity *
Sexual Orientation/Sexual Identity *
Gender Pronouns *
What is your primary mode of transportation? (ex. muni, car, bike, etc.) *
What benefits are you currently receiving? *
Required
Do you know how work income may or may not affect your benefits? *
What's your Emergency Contact (Name/Agency/Relationship/Phone Number)? *
Are there any dietary restrictions that we should be aware of? (Ex: Vegetarian, Allergic to nuts)
How did you hear about us? *
What do you hope we can help you with during the program (ex. resume and interview preparation)? *
What motivates you? Why do you want to work? *
What kind of job or field are you interested in? *
By signing below, I am agreeing that I have read, understood, and agree to the items contained on this form. You are consenting for NextGen to share your demographic information with San Francisco Department of Children, Youth and Their Families (DCYF), which will not be used to identify you in any way. Please enter your Full Name and Date Signed. *
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