2025 Youth Summer PAYS Application

2025 Youth Summer PAYS Application - PINELLAS

Before beginning the application, please note that the application must be completed in full to be submitted through this platform (If you are unsure of an answer, please type in 'N/A'). After submitting your application, you will receive a confirmation email. If you do not receive this confirmation email, it means your application was not successfully submitted, and we will not be able to access it. Please be advised that all youth will be required to verify their age, citizenship, right to work, and proof of free/reduced lunch or meet income guidelines in order to determine eligibility. EmployFlorida accounts are required to apply for the Youth Summer Program.

Youth First Name*

Youth Middle Name/Initial*

Youth Last Name*

Youth Phone Number*

Youth Email*

Alternative Contact Full Name (Parent/Guardian)*

Alternative Contact Relationship to youth (Parent/Guardian)*

Alternative Contact Phone Number (Parent/Guardian)*

Alternative Contact Email (Parent/Guardian)*

Physical Address*

City*

Select Your County (Only Hillsborough and Pinellas County Youth can participate)*

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Zip Code*

Full Mailing Address if different than above:

What area best describes your location?*

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Who is completing this application?*

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How did you hear about the Youth Summer Program?*

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Is this your first year participating in the Youth Summer Program?*

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Youth Summer Program Models available this year:

Paid Work Experience is internship positions working with local businesses. Youth will be introduced to the world of work. You will work for up to six weeks and have the opportunity to gain real-world experience, and life skills and get exposed to in-demand occupations.

Career Exploration is a four-week Online curriculum that allows young adults to explore potential career options, conduct research, participate in engaging activities, network and communicate with other youth with similar interests, and connect with some local business leaders in Pinellas County. The Career Exploration Model requires that the youth has access to a computer or a smartphone with internet access to complete assignments. CSHP will have a resource room with limited availability of computers and internet access. This program will be available on a first come first serve basis. (This is designated for all 15-year-old youth.)

Leadership (Young Leaders of Tomorrow) Consists of a six-week program for young adults that combines leadership and entrepreneurship training. It encourages responsibility, builds confidence, enhances employability skills, and fosters positive social behavior. This program prepares young adults for the world of work and equips them with essential tools for leadership roles and entrepreneurial success. Participants will also coordinate and execute a community project, putting their skills into action.

NOTE: If you previously participated in the Career Exploration program, you are ineligible to participate again.

Which program model are you interested in joining this summer?

Please select one (1) of the Summer Program Models*

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Are you currently in school?*

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What school are you attending?*

Student ID (Enter "0" if N/A)*

What is your current grade?*

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Are you at risk of being behind a grade level at the end of this school year?*

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Highest Education Level Completed (Select "No education completed" if still in High School or alternative school)*

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Current GPA

Current Anticipated Graduation Date

Will you be attending Summer School this year?*

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Have you registered for post-secondary classes?*

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If enrolled in post-secondary education, have you received or will you receive Pell Grant funds?*

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Do you have any occupational licenses/certificates*

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Youth Date of Birth*

Youth Current Age (Only youth between ages 15-24 can participate)*

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Youth Social Security Number (SSN)*

Youth Gender*

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Selective Service (For males 17 years and 11 months or older you will be required to register) Link to Selective Services:*

http://www.sss.gov/

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Authorization to Work/U.S. Citizenship*

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Considered to be of Haitian Heritage*

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Considered to be of Hispanic Heritage*

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Youth Race*

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Considered to have a disability?*

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If yes, do you require reasonable accommodations?*

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Do you have an IEP or 504 plan?*

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Eligible Veteran Status*

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Disabled Veteran*

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Homeless Veteran*

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What types of jobs are you interested in?*

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What is your employment status?*

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If employed, what is the name of your employer?

What is your hourly rate of pay?

On average, how many hours per week do you work?

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When did you start working with this employer?

Do you currently have a bank account?*

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Would you be interested in free banking?*

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What is your current household type?*

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Do you receive any Public Assistance? (Select all that apply)*

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Are you or your guardian receiving Reemployment Assistance?*

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Are you receiving WIOA services?*

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Are you residing in the home of a guardian?*

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Transportation Situation*

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Receiving free or reduced lunch*

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Are you a youth in or aged out of foster care?*

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Are you learning English as a second language?*

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Are you currently experiencing homelessness?*

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Have you been involved in the Criminal Justice System?*

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Are you a parent or expecting to be a parent?*

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What is the youth marital status?*

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How many people are living in the household, including yourself?*

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Essay Question: What would it mean to you and/or your family to be a part of the 2025 Youth Summer Program? What do you hope to take away from the program? (250 words or less)*

When the Youth Summer Program ends, if you are not hired by a worksite, would you still be interested in further employment opportunities?*

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Date of Birth Verification*

Acceptable Documents:

State Id / Driver's License / Permit

US Birth Certificate

US Passport

Alien Registration card

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Authorization to Work/U.S. Citizenship Verification:*

Acceptable Documents:

US Birth Certificate

US Passport

Alien Registration Card(Right to work)

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Social Security Number (SSN) Verification:*

Acceptable Documents:

Social Security card(signed)

W-2

School Transcript /documentation

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2024-2025 Free/Reduced Lunch Verification (If applicable):*

Acceptable Documents:

Current year Free / Reduced lunch letter from Student Nutrition

Student Profile Printout or Letter from Student Guidance Counselor

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Youth must complete the My Next Move Assessment (Upload Screenshot of Results)

https://www.mynextmove.org/explore/ip

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UPLOAD SECTION: All Required Documents can be uploaded HERE for faster processing.

Date of Birth Verification

Authorization to Work/U.S. Citizenship

Social Security Number (SSN)

2024/2025 Proof of Free/Reduced Lunch

My Next Move Results

**Please note: If you cannot upload at this time a team member will provide alternative options.**

Drag and drop files here or

EmployFlorida accounts are required in order to process your application. If you have not already created an account, please click on this link to create an account (If you already have an EmployFlorida Account, please enter Username below):

www.EmployFlorida.com

Youth Signature*

Parent/Guardian Signature if under the age of 18 (If you are 18 or older please type 'N/A'):*

Today's Date*

Send me a copy of my responses

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