If you have any questions concerning this registration form or general questions about the Summer Youth Works Program, please contact Paige Evans at
478-272-5546 or email 
Gender *
Primary Language *
In order to participate, you must be at least 16 years of age. Will you be at least 16 years of age on or before June 5, 2023? *
You must have reliable transportation in order to get to and from the jobsite. Do you have reliable transportation? *
Do you have any scheduled vacation plans this summer? *
Please read the below statements and sign off that they have been reviewed and agreed upon. *
Have you ever been convicted of a felony or any offense involving theft? *
If yes, select one of the following:
Do you have a valid drivers license or state ID? *
Are you willing to participate in an initial drug screening? *
Are you willing to work with animals? *
**If selected, we can not guarantee that you will be placed in your desired work interest.  We will make every effort to place you in a comparable position. 
**Interviews will be scheduled with each business on Thursday, April 19th at in the McGrath Keen, Sr. Conference Center at the Chamber of Commerce.  Interviews will be from 9:00AM to 11:00AM on that date.  Please see the contact person at your school for more details.