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2. About the Advancing Careers and Employment Program

   The ACE program seeks to provide youth who face barriers to employment with an opportunity to build skills, experience leadership roles, and gain valuable work. 

   The internship experience will run from mid-June to mid-August.

4. Personal Information
6. First Name*
7. Last Name*
9. Phone Number*
10. Email Address*
12. Address*
13. Apt/Unit Number
15. City*
16. State*
17. Zip Code*
19. Date of Birth*
    Date of Birth
21. Gender*

    1. Male
    2. Female
    3. Non-Binary
23. Race/Ethnicity*

    1. American Indian or Alaska Native
    2. Asian or Asian American
    3. Black, African American or African
    4. Hispanic or Latinx
    5. Native Hawaiian or Pacific Islander
    6. White or Caucasian
    7. Other
25. Are you between the ages of 16-24?*

    1. Yes
    2. No
27. Are you available to attend and complete the ACEentials training on May 6? *

    1. Yes
    2. No
29. Do you live in Hopkins or Minnetonka, or attend school in the Hopkins or Minnetonka School Districts? *

    1. Yes
    2. No
31. Emergency Contact First and Last Name*
33. Emergency Contact Phone Number*
34. Emergency Contact Email Address*
38. Education
40. What is your current school status?*

    1. Currently attending high school
    2. Currently attending an alternative school
    3. Currently attending Adult Basic Education (Adult Diploma or GED classes)
    4. Currently enrolled in college, trade school or apprenticeship
    5. Not currently attending any school program
42. What grade are you in?*

    1. 10th grade
    2. 11th grade
    3. 12th grade, did not graduate
    4. High School Diploma
    5. GED
    6. 1 Year Post-Secondary
    7. 2 Year Post-Secondary
    8. 3+ Years Post-Secondary
    9. Associate degree
    10. Other
44. Do you face a barrier to employment? Check all that apply.*

    1. I am eligible for free or reduced lunch at school.
    2. I have an Individual Education Plan or have a physical, mental, learning, emotional, or behavioral disability.
    3. I am pregnant, an expecting parent, or a parent.
    4. I am/will be the first person in my immediate family to receive a high school diploma.
    5. I am/will be the first person in my immediate family to graduate from college.
    6. I and/or my parents immigrated to the U.S.
    7. I am currently taking English Language Learner (ELL) classes.
    8. I have experienced homelessness or stayed in temporary housing in the last 6 months.
    9. I have received or am currently receiving foster care services.
    10. I have/a caregiver has had interactions with the criminal justice system.
    11. I dropped out of high school before receiving a diploma or GED, or am attending an alternative learning center.
    12. I am from a community of color who are under-represented in the workforce
    13. I receive (or someone in my family receives) public assistance
    14. I do not face a barrier to employment
    15. Other
46. I have a disability

    1. Yes
    2. Yes, but disability is not a barrier to employment
    3. No
48. I receive the following public assistance

    1. SSI
    2. SSDI
    3. TANF/MFIP
    4. SNAP/Food Programs
    5. General Assistance
    6. Refugee Assistance
    7. None of the above
50. Please explain
54. Internship Information
56. Are you able to commit to 18 hours per week, Tuesday through Thursday?*

    1. Yes
    2. No
58. Are you attending summer school?*

    1. Yes
    2. No
60. Will you be attending any other camps, programs, sports practices, etc. that will conflict with a summer internship?*

    1. Yes
    2. No
62. If yes, enter dates and time frames, if known
64. What type of internship would you like to work in? Select all that apply.*

    1. Administration and Finance
    2. Community Development and Inspections
    3. Fire Department
    4. Hopkins Activity Center
    5. Hopkins Center for the Arts
    6. Police Department
    7. Public Works
66. Do you have reliable transportation to and from work during the summer?*

    1. I will drive myself to work
    2. I will receive transportation from my guardian or trusted person
    3. I will take public transportation
    4. Other
68. How did you hear about this opportunity? *
72. Tennessen Warning*

    The ACE program receives state or federally funded resources. Therefore, we will have to collect personal and family information from you. 

    The information we are asking you to provide in this form is private, declared by Minnesota Statute 13.47 subdivision 2. We are obligated to inform you of the reason for collecting this data and how we will use the data. 

    You are not legally required to answer the questions, but it greatly assists us in determining the ability of us to serve you. 

    The data collected may be shared with other government organizations who have the legal authority to obtain this information such as U.S. Department of Labor, Office of Higher Education, Office of the Legislative Auditor, State Auditor, employment and training service providers, welfare agencies. 

    The collected data may be shared in a court order situation or with schools in which you may attend. 

    If you need more information or clarification on DEED data privacy policies, please visit http://mn.gov/deed/about/what-guides-us/privacy.

    Information that may be asked if you choose to proceed may include the following. 

    • Name, address, birth date, contact information, and emergency contacts: Used to identify you and connect with you. 
    • Gender, ethnicity, race, disability, veteran status, family status, and economic status: Assist with determining eligibility into the ACE program. 
    • Other personal information: Information such as work history and career goals help us to adequately match eligible participants to internships. 

    For applicants under 18, please get parent/guardian permission. This is an application for a paid internship and does not guarantee you a paid internship position, eligibility applies and youth accepted to the program will be formally notified. By submitting this application you acknowledge that you have read the above notice and understand the information may be shared with other service providers/agencies as stated.

    1. I understand
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74. 1. Receive an email copy of this form.
75. Email address

    This field is not part of the form submission.

76. Submit

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