STEP Participant Application

To begin, please complete and verify the following:

Are you a resident of Newport News?

To continue application fill out this form in it's entirety

Personal Information

First name

Middle name

Last name

Suffix

Date of birth

Date

Gender

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?

Employment

Were you a prior STEP Participant?

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

If you previously participated in STEP, why do you want to participate again?

Do you have any prior work experience?

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.

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.

How do you plan to attend mandatory program events and the daily work site?

Do you have a bank account in your name?

Bank Name (optional

How did you hear about STEP? Select one

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?

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.