Apprentice Program Summer 2024

* denotes a required field.

Applicant Information

First Name *

Last Name *

Email Address *

Phone Number *

Birthdate *

School Information

Name of High School *

Intended Graduation Year *

CEEB (hidden)

Level of Study (hidden)

What is you intended major of study. Please put N/A if you are still deciding.

Guidance Counselor Name

Guidance Counselor Email

Additional Questions

How did you hear about the Kinney Center? *

Why are you interested in participating in the Kinney Center's Apprentice Program? *

Please describe any previous experience (professional, volunteer, or informal) with individuals with an autism spectrum disorder (ASD). If you do not have any experience working with this population, that’s okay - please enter N/A below. *

Emergency Contact

Emergency Contact #1

First Name *

Last Name *

Relationship to Applicant: *

Other *

Phone Number: *

Emergency Contact #2

First Name *

Last Name *

Relationship to Applicant: *

Other *

Phone Number: *

Signature

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that this application is not intended to be a contract of employment. I understand that any false, inaccurate or misleading information contained in my application or provided by me during my interview will result in the denial of my application, or if already employed, in discharge from employment. I also understand that I am required to abide by all rules and regulations of Saint Joseph's University and the Kinney Center.

Students who are accepted to the Apprentice Program must obtain the following clearances before the start of the program. More information about each clearance will be given in the acceptance package.
* Pennsylvania State Criminal History Record (Act 34)
* Pennsylvania Child Abuse History Clearance (Act 51)
* Federal FBI Criminal History Report
* TB Skin Test

Students under the age of 18 after the start of the program must have working papers to be eligible to participate in the program.

I certify that I have read and agree with these statements. *

Apprentice Program Summer 2024

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