Project Launch Culinary Apprenticeship Application Save my progress and resume later | Resume a previously saved form Resume Later In order to be able to resume this form later, please enter your email and choose a password. Your Email: A Password: Confirm Password: Page 1 Online ApplicationPlease select... Yes No Thank you for your interest in Kitchens for Good's Project Launch Culinary Apprenticeship Program The Apprenticeship Program lasts 12 weeks and aims to prepare previously incarcerated persons, youth aging out of foster care, victims of domestic violence, individuals with mental/physical health disorders, and individuals with histories of substance of abuse for careers in the food-service industry. Below is a list of upcoming courses and application due dates. Please note that classes are Monday through Friday 8:30am to 4:30pm - attendance is mandatory. Upcoming Classes Class Number Application Due Date Class Start Date 14 September 3, 2018 October 3, 2018 15 November 12, 2018 December 12, 2018 16 January 27, 2019 February 27, 2019 17 April 8, 2019 May 8, 2019 18 June 17, 2019 July 17, 2019 Applications must be completely filled out to be considered. Kitchens for Good staff will review applications and invite selected candidates for interviews within 1 month of the class start date. Please note that submitting an application does not guarantee you an interview or a spot in the apprenticeship program. If the candidate successfully completes the interview, he/she will be scheduled to do a 4 hour trial shift in our kitchen.This application will take approximately 30 minutes to complete. To save and finish later click the link at the bottom of each page titled "save and resume later". All information in this application will be used by Kitchens for Good Staff to better understand each potential trainee's abilities, situation, and needs. Information will be kept confidential. If you have not done so already, please have your case manager or social services provider complete the Project Launch Culinary Apprenticeship Program Agency Referral Form. Case managers or social services provides can view program requirements and access the referral form at http://kitchensforgood.org/culinary-job-training/. Hard copy referrals can be submitted to email@example.com or at 404 Euclid Avenue, San Diego, CA 92114. If you do not have a case manager or social services provider please indicate that in the appropriate section of this application. Eligibility Requirements Please initial each line to indicate that you meet each eligiblity requirement. I Am 18 Years or Older I Am Eligible for Work in the United States I Am Currently Either Unemployed or Underemployed I Am Available to Be In Class From 8:30am to 4:30pm; Monday Thru Friday; No Exceptions I am Curious, Ready to Learn, and Able to Complete All Homework Assignments I Am Interested and Eligible to Work Full Time in a Food Service Career I Have No Outstanding Arrest Warrants I Have a Stable Housing Environment For the Next 6 Months I Am Drug Free and Sober For 120 Days Prior to the First Day of Class, and Willing to Undergo Random Drug Screening Before or During the Training I am Able to Stand For a Minimum of 8 Hours With Two 15 Minute Breaks and I am Able to Lift 50 Pounds With Reasonable Accomodations I Meet One of the Following Criteria (Select All That Apply):Please select... Legal Issues (Misdemeanors, Felonies, Parole, Etc.) Former or Current Foster Youth Victim of Domestic Violence Mental Health Disorder Substance Abuse Issues Signature Date Page 2 General Information Class Number Being Applied For See the prior page or go to http://kitchensforgood.org/applicants/ to view the class schedule. Applicant First Name Applicant Last Name Email Home Phone Mobile Phone Work Phone Other Phone Street Address City State Zip Code Do You Have I-9 Employment Documentation Please select... Yes No UnknownBirth Certificate, Social Security Card, Driver’s License or DMV Identification Card, etc. For Additional Information View the US Citizen and Immigration Services Web Page https://www.uscis.gov/i-9 Age GenderPlease select... Female Male Other Ethnic BackgroundHispanic/LatinoNot Hispanic/Latino Race Please select... White Black/African American Asian American Indian/Alaskan Native Native Hawaiian/Other Pacific Islander American Indian/Alaskan Native and White American Indian/Alaskan Native and Black/African American Black/African American and White Asian and White Other Multi-RacialSelect Other Multi-Racial if Your Race is Not Listed Did You Serve in the Armed ForcesPlease select... Yes No Unknown How Did You Hear About the ProgramPlease select... Agency Material (Flyer, Email, Etc.) Agency Referral Attended KFG Event Internet Job/Resource Fair KFG Marketing Material KFG Staff KFG Student KFG Volunteer Newspaper Office Walk In Other Radio Television Unknown Word of Mouth (Family, Friends, Etc.) If Other, Specify How You Heard of the Program Education History Did You Attend High SchoolPlease select... Yes No Unknown High School Name Did You Receive Your Diploma or GEDPlease select... Diploma GED None Year Graduated or Obtained GED Have You Had Any Vocational TrainingPlease select... Yes No Unknown Did You Receive a Vocational CertificatePlease select... Yes No Unknown Type of Vocational Certificate Did You Attend CollegePlease select... Yes No Unknown College Name Did You Receive a College DegreePlease select... Yes No Unknown Year Graduated or Obtained Degree Page 3 Work History Are You Currently EmployedPlease select... Yes No Who is Your Current Employer Please list all your work experience in the following space. Start with the last job you held. Include self-employment and any experience while incarcerated. Work Experience #1 (1) Employer Name (1) Position Held (1) Supervisor (1) Work Location (1) Employment Start Date (1) Employment End Date (1) Hourly Rate or Annual Salary (1) Reason for Leaving (Be Specific) (1) Duties Performed and Skills Used Work Experience #2 (2) Employer Name (2) Position Held (2) Supervisor (2) Work Location (2) Employment Start Date (2) Employment End Date (2) Hourly Rate or Annual Salary (2) Reason for Leaving (Be Specific) (2) Duties Performed and Skills Used Work Experience #3 (3) Employer Name (3) Position Held (3) Supervisor (3) Work Location (3) Employment Start Date (3) Employment End Date (3) Hourly Rate or Annual Salary (3) Reason for Leaving (Be Specific) (3) Duties Performed and Skills Used Page 4 Legal History Kitchens for Good will accept individuals with criminal records. Legal history will be used for record purposes only. What is Your Legal HistoryPlease select... Felony Misdemeanor Incarceration None Are You Currently On:Please select... Parole Probation Work Release None If Currently on Parole or Probation, or Work Release, for How Long If Currently On Parole, Probation, or Work Release, How Often/What Time Probation/Parole Officer Name Probation/Parole Officer Phone Do You Have Any Warrants?Please select... Yes No Do You Have Any Upcoming Court DatesPlease select... Yes No Do You Have Any Legal Problems?Please select... Yes No Warrant/Court Date/Legal Explanation Misdemeanor History If Legal History includes a misdemeanor, provide information in the following space. Misdemeanor #1 (M1) Misdemeanor Charge (M1) What Happened/Why? (M1) Were You Incarcerated/How Long? Misdemeanor #2 (M2) Misdemeanor Charge (M2) What Happened/Why? (M2) Were You Incarcerated/How Long? Misdemeanor #3 (M3) Misdemeanor Charge (M3) What Happened/Why? (M3) Were You Incarcerated/How Long? Felony History If Legal History includes a felony, provide information in the following space. Felony #1 (F1) Felony Charge (F1) What Happened/Why? (F1) Were You Incarcerated/How Long? Felony #2 (F2) Felony Charge (F2) What Happened/Why? (F2) Were You Incarcerated/How Long? Felony #3 (F3) Felony Charge (F3) What Happened/Why? (F3) Were You Incarcerated/How Long? Page 5 Case Management Do You Work With a Case Manager/ProgramPlease select... Yes No Program/Agency Name Case Manager Name Case Manager Phone Case Manager Email List Any Other Organizations You Work With (Career Center, TAENF, Etc.) Substance Abuse History Do You Have a History of Substance AbusePlease select... Alcohol Drugs None When is the Last Time You Used AlcoholPlease select... Never Over a Year Ago Within the Last Six Months Within the Past Year Within this Month Within this Week When is the Last Time You Used Illicit DrugsPlease select... Within this Week Within this Month Within the Last Six Months Within the Past Year Over a Year Ago Never Have You Been in a Drug or Alcohol Treatment ProgramPlease select... Yes No What Treatment Program/Facility and When How Long Have You Been Clean/Sober and What is Your Clean Date Kitchens for Good Has a Strict No Drug or Alcohol Use Policy During the Culinary Apprenticeship Program. Applicants Understand That:Kitchens for Good has a drug and alcohol policy that provides random and casual testing before and/r during the program,Applicant consents to and is in compliance with such policy at the time of enrollment, andApplicants continued enrollment is based on the successful passing of testing under such policy.If you agree with the above stated policy, sign below. Signature Date Housing Information What is Your Housing StatusPlease select... Friend Halfway House Homeless Other Own Permanent Subsidized Housing Relative Rent Shelter Transitional House If Other, Please Specify Do You Have Secure Housing for the Next 6 MonthsPlease select... Yes No If No, How Long Will You Have Secure Housing and What is Your Plan for Finding Housing Afterwards Foster Youth Information Are You a Current or Former Foster YouthPlease select... Yes No Unknown At What Age Did You Enter the Foster Care System Are You Still in Contact With Your Foster FamilyPlease select... Yes No Domestic Violence Information Are You a Domestic Violence VictimPlease select... Yes No Unknown Transportation Information Do You Have Transportation to Get to This Program on Time Each DayPlease select... Yes No Indicate Your Intended Source of Transportation Page 6 Mental/Physical Health Information Have You Ever Been Diagnosed With a Mental Health Disorder or Illness (Includes Developmental/Learning Disabilities)Please select... Yes No Unknown What is Your Mental Health Diagnosis Do You Have Any Physical Disorders (Includes Physical Disabilities)Please select... Yes No Unknown What is Your Physical Disorder Do You Take Any Medication That May Cause You to Experience Side Effects Such as Drowsiness, Impaired Motor Skills, or Impaired JudgementPlease select... Yes No What Medicines and Side Effects Do You Have a Food Borne Illness or Allergy That Prevents You From Working With Food (For Example, Hepatitis C)Please select... Yes No Explain Your Food Bourne Illness or Allergy Have You Ever Applied For:Please select... SSI SDDI IDA Head of Household/Income Information How Many People Are in Your HouseholdPlease select... 1 2 3 4 5 6 7 8 Are You the Head of HouseholdYesNo Does Your Household Have IncomeYesNo What is Your Household's Monthly Income What is Your Household's Annual Income What Are Your Household's Sources of IncomePlease select... I'm Employed Unemployment Social Security Social Security Disability Family Member Employed Cash Assistance Other None Do You Have Dependents (Children in Your Custody)YesNo If Yes, How Many DependentsPlease select... 1 2 3 4 5 6 7 8 How Do You Plan to Maintain Stable Childcare During the Program and While in Full Time Employment Are You Responsible for Other FamilyPlease select... Yes No Explain Responsibility for Other Family Select the Appropriate Category Based on Your Household Size and Income. The "How Many People Are In Your Household" Question Above Should Match the Number Selected in This Question. Please select... 1 - $0 - $20,450 1 - $20,451 - $34,100 1 - $34,101 - $54,500 2 - $0 - $23,400 2 - $23,401 - $38,950 2 - $38,951 - $62,300 3 - $0 - $26,300 3 - $26,301 - $43,800 3 - $43,801 - $70,100 4 - $0 - $29,200 4 - $29,201 - $48,650 4 - $48,651 - $77,850 5 - $0 - $31,550 5 - $31,551 - $52,550 5 - $52,551 - $84,100 6 - $0 - $33,900 6 - $33,901 - $56,450 6 - $56,451 - $90,350 7 - $0 - $38,060 7 - $38,061 - $60,350 7 - $60,351 - $96,550 8 - $0 - $42,380 8 - $42,381 - $64,250 8 - $64,251 - $102,800The numeric digit in front represents the household size while the currency values represent a range of income I hereby certify that the above information is complete and accurate to the best of my knowledge. The income estimate includes income for all household members. I agree to submit additional support documentation if requested by Kitchens for Good. Falsification of information may result in adverse actions against me including recapture of any benefits resulting from false information submitted. By checking here, I hereby declare that I am homeless residing predominately within the City of San Diego By checking here, I hereby certify that I do not have income to report Signature Date Page 7 Goals Questionaire Please answer the following questions. Responses should be 2-4 sentences each. Why Are You Applying to This Program? What Are Your Career Goals? What Do You Hope to Get Out of This Program? Why is it Important For You to Be Selected for This Program? What Are Your 2 Best Personal Strengths? What Skills Do You Bring to the Program? What Have Been the Main Life Challenges in Your Life Recently? How Have You Dealt With Life Challenges? Do You Have Any Prior Food or Kitchen Experience (Employment, Volunteer, Education)? What Interests You About Working in the Culinary Industry? Page 8 Agreement to Program Requirements Listed below are some of the Apprenticeship Program requirements. Please check the box next to each requirement if you agree with them. I Understand That Daily Attendance is Required I Understand That I Am to Remain Drug and Alochol Free I Understand That I Must Be On Time and Prepared to Stay the Entire Day (8:30am - 4:30pm) I Understand That I Must Be Willing to Accept Instruction and Criticism From My Instructors and Supervisors, and Complete Work Assigned to Me With a Positive Attitude I Understand That I Must Have a Willingness to Confront My Personal Challenges and/or Barriers Listed below are some of the Apprenticeship Program disclaimers. Please check the box next to each disclaimer if you agree to them. I Understand That if I Am Accepted Into the Program I Will Not Get Paid During Instructional Hours of the Program I Hereby Grant Permission to Kitchens for Good to Contact References, Caseworkers, or Probation/Parole Officers Listed in This Application to Ask Questions Regarding My Character, Personality, Work Habits, and Abilities as They Relate to the Apprenticeship Program. I Release These References From All Liability and Responsibility That May Result From Providing Kitchens for Good With Such Information as Requested I Hereby Grant Permission to Any of My References or Referral Agencies to Provide Confidential Information About Me to Kitchens for Good. All Information Received Will Be Used by Kitchens for Good Staff to Better Understand Each Potential Apprentices Abilities, Situation, and Needs. Information will be Kept Confidential I Authorize Investigation of All Statements Contained in This Application. I Understand That the Misrepresentation or Omission of Facts Called For is Cause For Dismissal at Any Time Without Any Previous Notice. I Hereby Give Kitchens for Good Permission to Contact Schools, Previous Employers (Unless Otherwise Indicated), References, and Others, and Hereby Release Kitchens from Good From Any Liability as a Result of Such Contact I Certify That Everything Provided in This Application is True and Correct to the Best of My Knowledge Signature Date Save my progress and resume later | Resume a previously saved form Need assistance with this form?