Youth Worker Application Application for youth workers to the 2017 NOCCC Youth Summit The NOCCC has an exciting opportunity for local youth! Want to gain valuable leadership experience and have a profound impact on the health of your peers in Omaha? Want a sweet addition to your resume while also being creative and fun? The NOCCC is looking to hire 4-5 youth leaders to plan and implement a youth summit in North Omaha in September 2017 at Metro Community College. This youth summit will feature speakers and workshops on mental health, access to health care, education and career success, sexual health, life skills, healthy relationships, and adolescent development. Additional workshops featuring art, music, poetry and more may be added. You will be paired with a mentor that will assist you during the planning process and will support you. Important things to know regarding this project and your eligibility: • Must be 14-19 years of age. • Must attend an orientation to the project with a parent/guardian/caregiver (tentatively first part of June, 2017) and conference on September 23, 2017. • Must be able to attend 1-2 weekly meetings (early evening, weekends). The time commitment may vary from 4-8 hours per week, depending on your designated committee. • Stipends available up to $1,000! • Awesome skill sets we need? Organization and planning, collaborative teamwork, social media skills, great relationships with other youth in the community, etc. Timeline: Complete the application online, submit via email to mail@northomahaccc.org, or send by mail to PO Box 31341 Omaha, NE 68131 no later than May 24th (applications must be received by this date). You will be asked to interview with a small group of adult leaders the week of May 29th with your availability to start work the week of June 5th, 2017. If you have any questions, please contact Aja Anderson at 402-916-5293 or at mail@northomahaccc.org. We look forward to hearing from you! In gratitude, NOCCC Full Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone* Email* Are you available June 5?* Yes No Are you a citizen of the United States?* Yes No If no, are you authorized to work in the U.S.? Yes No Date of Birth* MM slash DD slash YYYY Age now* EDUCATIONHigh School From: To: Did you graduate? Yes No College/Trade School From: To: Did you graduate? Yes No Degree REFERENCESReference #1 Name* Relationship* Company* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Reference #2 Name* Relationship* Company* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*PREVIOUS EMPLOYMENTCompany* Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Supervisor Job Title ResponsibilitiesFrom MM slash DD slash YYYY To MM slash DD slash YYYY Please rank the project you desire to work on (1 being your first choice, 4 last choice) Breakout Speakers*Please enter a number from 1 to 4.Help in the process of picking speakers and working on the logistics for speakers to ensure a great experience for our youth in attendance. Transportation*Please enter a number from 1 to 4.Coordinate registration and transportation for conference attendees and designate pick-up and drop-off times with the transportation agency Incentives*Please enter a number from 1 to 4.Help determine what incentives will be given and gathering all incentives. This may include making “swag” bags for the conference attendees, gifts for speakers, and raffle prizes. Registration/Promo*Please enter a number from 1 to 4.Assist with the planning, coordination, set up, and execution of registration for the event. This may include working the registration table the day of the event. Please attach copies of documents and/or awards that you might want us to consider in accepting you in this program. File Drop files here or Select files Accepted file types: jpg, gif, pdf, doc, docx, png, Max. file size: 12 MB, Max. files: 3. Briefly tell us what you believe is the biggest health-related issue impacting Nebraska youth?
