Paynesville-Sauk Centre CareerONE Online Request Form

Priority given to applications received by May 1, 2020. Requests accepted until June 22, 2020
**Must be OVER 14 and UNDER 18 years old to submit a request.

How many family members live with you?
What is your family's total MONTHLY income?
(Income is based on Federal Register guidelines)
Gender:*
(Optional) Race:

Applicant/Parental/Guardian Consent
By typing my signature below I give permission to share my/the youth’s name with their school/county human services/corrections, for purposes of verifying the above information, and to obtain school records. These school records include, attendance, transcripts, IEP/504, vaccinations, discipline and MCA/STAR scores. In order to be considered for this program, I understand that I have to demonstrate reading and math skills at a 5th grade level on the TABE assessment. I also agree that I/they can read social cues, show that I/they can work safely in a team setting with minimal supervision, and I/they am in control of my emotions.
Youth Signature*
First Last
Parent/Guardian Signature*
First Last
Signature Date*
MM slash DD slash YYYY

Eligibility Information