Local Conservation Corps (LCC) Application

Local Conservation Corps

LCC provides young adults (ages 18-25) with
paid job training and educational opportunities.

Eligibility

Check eligibility to participate in Fresno EOC LCC

YouthBuild Charter School

On-site high school diploma completion program

APPLICATION FOR CORPSMEMBER TRAINING POSITION

In order for your application to be considered for a corpsmember training position, please complete all sections.

LCC - Application Form

Name*
First Last
Preferred Name
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Cell Phone #*
Email Address*
If accepted into the LCC program, can you provide proof of legal right to work in the U.S.?*
- Yes
- No
Your Age:*
- 18-19
- 20-21
- 22-23
- 24-26
If accepted into the LCC program, will you be able to provide the following?*
Check all that apply:
- Social Security Card
- Birth Certificate
- California ID or Driver’s License
- Proof of Household Income (i.e., Wiz report, check stub from yourself or someone in the household, SSI, etc.)
Have you ever participated in Fresno EOC Local Conservation Corps as a corpsmember?*
- Yes
- No
What program did you participate in?*
What dates were you in the program?*
Have you ever participated in YouthBuild Charter School of California?*
- Yes
- No
If accepted into the LCC what days are you available to work?*
Check all that apply:
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
- Sunday
What hours are you available to work on the days you selected?*
Check all that apply:
- Morning
- Afternoon
- Evening
How did you hear about LCC?*
Check all that apply:
- Social Media - Facebook, Instagram, Twitter, etc.
- Internet Search (Google, Bing, Yahoo, etc.)
- Friend/Family
- Other
Other*

Please tell us how you heard about LCC here.
Do you have reliable transportation?*
- Yes
- No
Explain your transportation problem*
Education Status:*
Select one:
- I have a GED
- I have a High School Diploma
- I have not completed HS Diploma or GED
What is the highest grade you completed?*
- 8
- 9
- 10
- 11
- 12
If you are accepted into the LCC program, you will be required to enroll in a formal education program (high school, college, career tech). Are you willing to do this?*
- Yes
- No
Are you currently enrolled in an educational school/program?*
- Yes
- No
Name of School/Program:*
Work History
List your current or most recent job first; include volunteer work history
Employer 1 Name
Employer 1 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employer 1 Phone
Dates you worked for this employer:
From Month, Day, Year to Month, Day Year
Job Title
Hourly Wage
Hours per Week
Reason for Leaving
Employer 2 Name
Employer 2 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employer 2 Phone
Dates you worked for this employer:
From Month, Day, Year to Month, Day Year
Job Title
Hourly Wage
Hours per Week
Reason for Leaving
- I need to add more employers
Employer 3 Name
Employer 3 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employer 3 Phone
Dates you worked for this employer:
From Month, Day, Year to Month, Day Year
Job Title
Hourly Wage
Hours per Week
Reason for Leaving
Employer 4 Name
Employer 4 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employer 4 Phone
Dates you worked for this employer:
From Month, Day, Year to Month, Day Year
Job Title
Hourly Wage
Hours per Week
Reason for Leaving
Employer 5 Name
Employer 5 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employer 5 Phone
Dates you worked for this employer:
From Month, Day, Year to Month, Day Year
Job Title
Hourly Wage
Hours per Week
Reason for Leaving
Why are you interested in joining the Fresno EOC Local Conservation Corps?*
References
List the names, addresses, and phone numbers of two persons, not relatives, who are familiar with your personal background, education, employment, and/or skills.
Reference 1 Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Occupation*
Relationship*
Reference 2 Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Occupation*
Relationship*
Declaration
I hereby certify that all statements made in this application are true and correct. I agree and understand that any misinformation or material omission could result in disqualification from the LCC Program. I understand that acceptance into the LCC program is contingent upon satisfactory completion of all pre-service requirements including, but not limited to interviews, non-paid orientation, reference checks, verification of legal right to work in U.S., and for certain positions, a criminal background check which will include an arrest record. Note: Conviction of an offence, including a felony, may not disqualify you for enrollment.

In the event that any or all of the above pre-service requirements are not met, I understand I will not be accepted into the LCC program.

I authorize organizations and persons named above to give information about me, and I release them from all liability.
Type Name Here
Signature
Date of Signature*
MM slash DD slash YYYY
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Local Conservation Corps

Eligibility

YouthBuild Charter School

APPLICATION FOR CORPSMEMBER TRAINING POSITION

LCC - Application Form

Work History

References

Declaration

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