Summer Work Application

The Summer Employment Program is sponsored by UCSD #4 and NextGen Mentoring.

Student Name*
First Last
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Guardian's Name*
First Last
Guardian's Phone
Cell Phone*
Age
Grade
Email*
Have you been involved with the Summer Work Program?
- Yes
- No
Work History
Where have you worked (list all work experience & year: babysitting, ranching, etc.)
Place Worked & Year
What did you like about it? What did you dislike?
Place Worked & Year
What did you like about it? What did you dislike?
Place Worked & Year
What did you like about it? What did you dislike?
Place Worked & Year
What did you like about it? What did you dislike?
Additional Information
Where would you like to work and why (starting with number one choice)?*
Please list any vacations or camps you will be involved in during the summer:
When can you start to work?*
Is transportation an issue?
- Yes
- No
CAPTCHA

Work History