Summer Youth Application 2012
Tuesday, 05 January 2010 16:25
Sloss Summer Youth Apprenticeship: June 4– July 27, 2012
Application Form
Application Deadline:
Postmarked No Later than April 25, 2012
Students must be 16 by June 4.
Please answer all questions and send application, references and portfolio to:
Sloss Summer Youth Apprenticeship
PERSONAL INFORMATION (Please print clearly)
Name __________________________________________________________________
Address ________________________________________________________________
City _____________________ Zip __________________ email ___________________
Home Phone ___________________________ Cell Phone, if any___________________
Age you will be on June 4, 2012 _______ Birth Date _______________________________
Gender: _____ Male _____ Female
Ethnic Origin:
_____ African American _____ Native American _____ Latino
_____ European American _____ Asian American _____ Other
Type of School: _____ Public _____ Private _____ Catholic
Emergency Contact: _______________________ Daytime Phone __________________
Relation to you: __________________________________________________________
The Sloss apprenticeship requires a commitment of 30 hours per week for eight weeks. Will you be able to attend all sessions?
Sloss is an equal opportunity employer. Do you have any special needs or physical limitations that need accommodation? Please describe.
Applicant Signature _______________________________ Date ___________________
The following information is required by the Apprenticeship Program for statistical purposes only and is strictly confidential. Check the yearly income range of your household and family:
_____ 0 - $7,500 _____ $15,201 - $17,800
_____ $7,501 - $10, 050 _____ $17,801 - $22,300
_____ $10,051 - $12,600 _____ $22,301 - $28,000
_____ $12,601 - $15,200 _____ More than $28,000
How many people, including you, live in your household? ______________
ABOUT YOU:
(You must answer each question)
What other jobs have you held in the past?
What makes you a good employee?
Who is your favorite artist?
What do you like about his/her work?
Who or what most influences your interest in art?
What is your favorite art form? Circle one.
Painting Architecture Photography
Video Jewelry Printmaking
Sculpture Dance Music
Theater Writing Other ______________
Briefly describe your interest, background and experience in art. (Attach additional page if necessary.)
What do you expect to gain from this experience?
Please attach recommendations to this page.