STEP Participant Application

STEP

Participant Registration
To begin, please complete and verify the following:
Are you a resident of Newport News?

YesNo
To continue application fill out this form in it's entirety
Personal Information
First name
Middle name
Last name
Suffix
Date of birth

MonthDayYear
Date
Gender

MaleFemale
Personal Information
Contact Information
Street address
Apartment /Unit (optional)
City
State
Zip code
Primary phone number
Alternate phone number (Optional)
Email Address
Education
What is the highest level of education completed?
Are you currently enrolled in college/university? State yes or no and school name.
College major (optional)
Would you like to receive information for a GED program?

YesNo
Employment
Were you a prior STEP Participant?

YesNo
If you are a prior STEP participant, please select the years you were in the program.

2014201520162017
If you previously participated in STEP, why do you want to participate again?
Do you have any prior work experience?

YesNo
Prior job titles and/or positions held
Prior job duties
Do you have a resume? Yes or No
Below is a sample of positions available. Please select at least three that interest you.

Office; paperwork, organizing, answering phonesHospitality and tourism; welcoming and guiding visitorsGeneral cleaning and maintenance (inside)School cleanup; setup for next school yearGeneral Cleaning & MaintenanceWorking with Children (requires background check)Artistic Design & CreationFuneralMedicalRestaurant/Food ServiceCulinary Program (Must be at least 18 years of age)Landscape/Lawn CareManufacturingAnimal Care/ EngagementAny of the AboveOther
Additional Information
Additional Information
What is your t-shirt size?
Have you ever been convicted of a crime or have any pending charges? Please note, if selecting yes, you will not automatically be disqualified for the program.

YesNo
How do you plan to attend mandatory program events and the daily work site?
Do you have a bank account in your name?

YesNo
Bank Name (optional
How did you hear about STEP? Select one

SchoolFriendNewsSocial ServicesFacebookCity of Newport NewsOther
How did you hear about STEP?
What are your concerns for successfully completing the program? Do you have any concerns being involved in STEP?
Why do you want to participate in this program?
Describe your future career, education, or other personal goals.
Describe the biggest challenge you may face trying to achieve your goals.
What are your plans upon completion of the program?
Applicants under 18 will need approval from a parent /guardian in order to participate in STEP. The parent/ guardian will also be required to attend a mandatory program registration session. If I am under 18, my parent/ guardian granted me permission to participate in this program?

YesNoNot applicable, I am 18
Parent Name
Parent Phone Number
By typing your name in the box below, you are certifying the information in this application is true and complete to the best of your knowledge. You MUST hit submit below to send this application.
By submitting this form, I certify that all information and statements I have provided in this registration are current, correct, and complete to the best of my knowledge.
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