Application for Employment February 8, 2010
First Name:
 MI:
 Last Name:
Email:
 Home Address:
 City:
County: (not COUNTRY)
 State:
 Zip Code:
Phone:
 Cell Phone:
 Citizen of:
Driver's License Number:
 State Issued:
Permanent Mailing Address (if different from above):
Address:
 City:
 State:
Zip Code:
 Date of Birth:
Optional Information:
How did you hear of Northwest Youth Corps? (Required check all that apply. Hold down CTRL or Apple key to select more than 1)
   If Other, please specify:
Position applied for:
1. Education and Training:
SchoolDates AttendedDegree
2. Certification:
NYC staff who work directly with youth must hold current First Aid and CPR certifications before starting work. Check all areas below in which you are currently certified.
Wilderness First Aid EMT CPR
Standard First Aid Life Guard WFR
Advanced First Aid First Responder WSI
(Please list other if applicable.)
3. Background:
Have you had any driving citations during the last three years? Please note that one job requirement of all field staff is that they must have had a driver's license for at least three years prior to working with NYC
yes no
If you have answered yes, please explain below.
(Positive responses will not necessarily bar an applicant from employment.)
4. Position Description:
Have you examined the description for this position?
yes no
Do you understand and can you meet, the requirements of this position?
yes no
5. Communication:
Do you possess interpretive skills in American Sign Language?
yes no
Please list any languages in which you are fluent other than English.
6. Limitations:
Do you have any physical condition or limitation which may affect your ability to perform the position applied for?
yes no
(If yes, what can be done to accommodate your limitations? Please explain.)
Application Requirements
  • Cover Letter
  • Completed and Signed Application
  • Employment History: Include a copy of your resume.
  • Four References: Please attach a list of four references who are familiar with your ability to perform the job applied for. At least two of the four must be supervisors from recent jobs. Specify your relationship, their professional affiliation and their current home and work phone numbers.
  • Narrative questions and additional information may be requested for the position you are applying for prior to scheduling an interview.
Certification and Release
I certify that the information provided in this application is true and accurate to the best of my knowledge. I understand that false information, or misrepresentation of facts, may result in rejection of this application or be grounds for immediate dismissal.

NYC policy prohibits the possession of alcohol or use of tobacco products while supervising youth; staff must maintain a substance free life-style throughout their employment period. NYC policy prohibits staff from engaging in romantic relations with program participants during, or following their employment. If offered a position with NYC, you will be required to furnish proof of U.S. citizenship, or proof that you are authorized to work legally in the United States, before starting work. Criminal history, if any, will be reviewed for job relatedness. A valid driver's license and driving record acceptable to NYC and NYC's insurance carrier will be required. I authorize NYC to verify any of this information including, but not limited to, driving record, criminal record, and employment history.

To complete application requirements online, you may attach your documents using the form below or email your cover letter, resume and references to: nyc@nwyouthcorps.org.

Upload and Attach Cover Letter  
Upload and Attach Your Resume
Upload and Attach References   


If submitting on line, by typing your name below you certify that the statements made on this application are true and accurate.

Name of Applicant:
Northwest Youth Corps is an equal opportunity employer.

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