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Email*

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245 State St. SE; 2nd Floor
Grand Rapids, MI 49503
616-456-3558

sharris@grand-rapids.mi.us
zlaraway@grand-rapids.mi.us

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Step 1 of 10 - Contact Information

10%

Summer Session: June 8 – 19, 2020
Application Deadline: May 27, 2020
Ages 15 to 24 Only
Which training session are you applying for?*
- Spring Session
- Summer Session
Name*
First Last
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Phone
Email (We'll contact you via email)*
Race or Ethnicity
Gender
Date of Birth
MM slash DD slash YYYY

Are you authorized to work in the United States?
- Yes
- No
Have you been involved in any disciplinary action in the last school year?
- Yes
- No
Please Explain:
Have you ever been convicted of a misdemeanor or a felony?
- Yes
- No
This does not eliminate you from the LEAD Program application process.
Please Explain:
Participants must complete training BEFORE they are eligible for employment. Are you available during the training dates listed above?
- Yes
- No
Which dates are you not available?

NOTE: Please hit the tab button for the "Next" button to appear.
Name of High School or GED Program
Highschool City/State/Zip
GPA
Date Started
Date Finished
Have you Graduated?
- Yes
- No
Current Grade Level
- Freshman
- Sophomore
- Junior
- Senior
Name of College/University
College/University City/State/Zip
Course of Study / Major
Date Started
Date Finished
Have you graduated? (College/University)
- Yes
- No
Level of Degree (Associates, Bachelors, etc)
Other School
Location
Date Started
Date Finished
Have you graduated?
- Yes
- No
Degree / Certification

Name
First Last
Relation to you
Email
Phone
Name
First Last
Relation to you
Email
Phone

If you have no work experience, please write-in N/A in the “company” slot. Resumes will be accepted but not in lieu of this application.

NOTE: Please hit the tab button for the "Next" button to appear.
Company (1)
Phone
Address
Street Address / City / State / Zip Code
Supervisor:
Job Title
Starting Hourly Wage or Salary - Ending Hourly Wage or Salary
Job Responsibilities
Date Started
Date Finished
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No

NOTE: Please hit the tab button for the "Next" button to appear.
Company (2)
Phone
Address
Street Address / City / State / Zip Code
Supervisor:
Job Title
Starting Hourly Wage or Salary - Ending Hourly Wage or Salary
Job Responsibilities
Date Started
Date Finished
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No

NOTE: Please hit the tab button for the "Next" button to appear.
Company (3)
Phone
Address
Street Address / City / State / Zip Code
Supervisor:
Job Title
Starting Hourly Wage or Salary - Ending Hourly Wage or Salary
Job Responsibilities
Date Started
Date Finished
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No

NOTE: Please hit the tab button for the "Next" button to appear.
I have read the Michigan Department of Energy, Labor & Economic Growth Youth Employment Standards.
Read the standards here:
- Yes
- No
What professional fields interest you?
Choose up to 3 responses
- Agriculture
- Advertising
- Automotive
- Banking
- Business
- Construction
- Computer/Web
- Cosmetology
- Customer Service
- Education
- Military
- Engineering
- Entertainment
- Fashion
- Government
- Healthcare
- Hospitality
- Journalism
- Law
- Manufacturing
- Maintenance
- Non-Profits
- Performing/Visual Arts
- Police/Fire
- Retail
- Sports
List Hobbies or Special Talents
List clubs, organizations, and/or volunteer projects in which you have been involved:
Annual Household Income
This is the sum of income of everyone that lives in your house
How many people live in your household?

In your essay, address why should you be chosen to participate in the LEAD program. Describe achievements, characteristics and/or special qualities that will set you apart from other applicants. Include what level of commitment you will make to the LEAD program and your subsequent employment opportunity. In addition, tell us what you hope to learn while in the program. Lastly, describe your dream career and how you plan to obtain it.
Essay Upload:
Upload your 1 page, double-spaced, essay here.
Max. file size: 512 MB.
Resume Upload (not required)
Max. file size: 512 MB.
Those completing the program have the opportunity to be a paid employee at a company that is part of the Mayor’s 100 Campaign. Go to http://ourcommunityschildren.com/occ-ppp/mayors-100-businesses/ for a list of companies.

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to acceptance into the LEAD program and ultimately into employment, I understand that false or misleading information in my application or interview may result in my release.
NOTE: Please hit the tab button for the "submit" button to appear. Hit "submit" to complete your application.
Signature of Applicant
Hidden
Date
Signature of Parent or Guardian (if applicant is under 18)
Date
A required group interview will BE SCHEDULED THROUGH EMAIL CORRESPONDENCE.
Applicants will be notified about their acceptance by email.
Name
This field is for validation purposes and should be left unchanged.

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COMPANY INFORMATION
Company Name
Street Address
City
State
Zip Code
Phone
Email
Fax
Web Address
Contact Name
Street Address
City
State
Zip Code
Phone
Email
Fax
This company has experience in hiring students as employees and/or interns.
- Yes
- No
The City’s Web Procure on-line vendor application has been completed.
- Yes
- No
Type of Business
- Manufacturing
- Wholesale
- Distributor
- Service
- Non-Profit
- Automotive
- Maintenance
- Government
- Medical
- Retail
- Entertainment
- Hospitality
- Computer/Web
- Advertising
- Broadcasting
- Other
This company is fully aware of and abides by the Michigan Youth Employment Standards Act.
- Yes
- No
Are you a member of the Grand Rapids Chamber of Commerce?
- Yes
- No
Number of Employees in Company
Please check the dates in which your company will be able to employ students that have successfully completed the LEAD (Leadership and Employment, Achievement and Direction) program and/or a youth leadership program facilitated by Our Community’s Children and its partners. Choose all that apply.
- Summer 2020
- Fall 2020
- Winter 2020
- Sometime in 2021
- Other
Please indicate Dates:
Will you provide PPE to your employees to prevent the spread of COVID-19 during their employment?
- Yes
- No
- Unsure
COMPANY DESCRIPTION
Please use this space to describe your company’s history, mission, products or services sold, information you would like to share about your company’s successes and explain why your company is interested in becoming part of the Mayor’s 100.
JOB DESCRIPTION
Job Title(s)
Number of Positions
Projected Number of Hours Per Week Per Student and Indicate Part-time or Full-time
Please attach a Job Description with application that includes:
Max. file size: 512 MB.
• Description of duties to be performed • Name of department • Qualifications
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. This company agrees to provide meaningful jobs for young men and women in high school and/or college. As part of the Mayor’s 100, this company agrees to share 50% of the cost of employing a young person for up to 240 hours with the City of Grand Rapids. The City’s financial contribution is based on a job assignment that pays at least $10.00 to $13.00 per hour (including withholdings). This company understands that we may choose to pay higher wages and hours at our own expense. During this employment commitment, this company understands that it will have access to a Program Coordinator through Our Community’s Children to ensure a successful placement.
Date
MM slash DD slash YYYY
Signature
Comments
This field is for validation purposes and should be left unchanged.

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Step 1 of 5 - Applicant Information

20%

Applicant Information
Name
First Last
Street Address
(Must Live in the City of Grand Rapids; no exceptions will be made.)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email*
Race of Ethnic Background (optional)
Date of Birth
Gender
- Male
- Female
- Trans male
- Trans female
- Non-binary
In which City Ward do you live?
( Go to www.grcity.us, call the county clerks at 456.3010, or check the map here:
- 1st
- 2nd
- 3rd
How did you hear about the Mayor's Youth Council?
- Email
- Flyer
- Social Media
- Word of Mouth
Who told you?

Education
Name of High School
City
State
Zip Code
Grade Level
Current GPA

References
Please list Two professional or character references; must be a Non-family member and not a high school student.
Name
First Last
Relationship to you:
Company
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name (Reference 2)
First Last
Relationship to you:
Company
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Tell us about yourself
List your hobbies and Special Talents
List clubs, organizations and/or volunteering in which you have been involved.
Describe why you should be selected to be a Council Member and what you hope to accomplish for other teens that you would represent.
What is the most critical issue facing youth in Grand Rapids?
What would you like to know about City Government and why?
After graduating from high school, what are your academic and/or career goals?

Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge.

MEMBERSHIP ON THE MAYOR’S YOUTH COUNCIL DEMANDS STRICT ATTENDANCE. ALL PARTICIPANTS ARE REQUIRED TO SIGN A CONTRACT AGREEING TO FULL PARTICIPATION AND LAWFUL AND APPROPRIATE CONDUCT WHILE ON THE COUNCIL. THERE WILL BE TWO FORMAL MEETINGS PER MONTH ALONG WITH SUBCOMMITTEE MEETINGS AND MANDATORY SCHEDULED ACTIVITIES. SOME ACTIVITIES OCCUR DURING SCHOOL HOURS. COUNCIL TERMS ARE FOR ONE SCHOOL YEAR – NOVEMBER TO MAY. SIGN ONLY IF YOU CAN MAKE SUCH A COMMITMENT.
Name of Applicant
Date
MM slash DD slash YYYY
You must live in the City of Grand Rapids; no exceptions will be made.

Group interviews will be virtual. Applicants will be notified about their  interviews and acceptance into the program by email.  Please check your email for important information.  
Read more about the Mayor's Youth Council here
Comments
This field is for validation purposes and should be left unchanged.

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