SHEBOYGAN AREA
YOUTH APPRENTICESHIP PROGRAM
2016 GENERAL APPLICATION GUIDELINES
Have you discussed the commitment of an apprenticeship with your parents/guardians? Do you
understand that applying for an apprenticeship does not guarantee an interview? If hired, will you be
able to work before, during or after school? How about weekends, holidays and over the summer?
Every student interested in participating in Youth Apprenticeship will be required to complete
the application process. All applications must be TYPED. The application includes the
following:
I. Background Information and Time Commitment Forms
II. Parent or Guardian Information
III. Parent/Guardian Certification and Release Form
IV. Employment History
V. Applicant Program Interest Essay
THE LINK TO COMPLETE THE ELECTRONIC APPLICATION CAN BE FOUND AFTER
FEBRUARY 9, 2016 AT:
http://www.gotoltc.com/future-students/high-school/YA/apply/index.html
YOU MUST SUBMIT THE FOLLOWING DOCUMENTS WITH THIS APPLICATION
1. A copy of your high school transcript.
2. A copy of your high school attendance record for the current year.
3. Two recommendations are required—teacher/staff put in sealed envelope which will be
turned in to the high school YA liaison.
 One high school program related teacher—such as for Engineering—a Math or Tech Ed.
Teacher, for Health—a Health or Science teacher, etc.
 One high school staff (non-program related)—such as a guidance counselor, non-program
related teacher, coach, club or supervisor for volunteer work
-- Please see forms for submission requirements.
Revised 1/22/2016
Sheboygan Area Youth Apprenticeship
2016 GENERAL APPLICATION FORM (click in the grey boxes only)
STUDENT NAME:
DATE:
HIGH SCHOOL:
Check the boxes for the program area for which you are applying:
AGRICULTURE (check one)
Plants
Animals
ARTS/AV TECH/COMMUNICATIONS
FINANCE: (check one)
Pre-Press
Accounting
Banking
HOSPITALITY, LODGING & TOURISM (check one)
Culinary/Restaurant/Food Service
Lodging/Front Office/Housekeeping
STEM: (check one)
Bio Science Lab
Mechanical Design
MANUFACTURING: (indicate your choice of program- 1 being the highest , 3 being the lowest)
Assembly/Packaging
Industrial Maintenance
Machining
Johnsonville Food Production (Seniors Only)
Production Operations(Quality Assurance)
Welding
TRANSPORTATION (check one)
Auto Technician
Supply Chain Management
ARCHITECTURE & CONSTRUCTION (check one)
Architectural Design
Electrical
Construction
INFO TECHNOLOGY (check one) IT Essentials
Web & Digital Media
STUDENTS
RETURN COMPLETED APPLICATION AND DOCUMENTS
TO YOUR HIGH SCHOOL YOUTH APPRENTICESHIP LIAISON BY
FEBRUARY 26, 2016
LTC YOUTH APPRENTICESHIP COORDINATOR WILL PICKUP AT HIGH SCHOOL
DEADLINE: March 3, 2016
No individual shall be excluded from participation in, denied the benefits of, subjected to discrimination under, or denied employment in the
administration of or in connection with any Wisconsin Youth Apprenticeship Program on the basis of race, color, religion, sex, national origin, age,
handicap, political affiliation or belief, or sexual orientation.
Revised 1/22/2016
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Sheboygan Area Youth Apprenticeship Application
I. BACKGROUND INFORMATION
Student Name
Address
City
Zip
Date of Birth
Phone
Cell Phone
High School
E-mail
Grade level for 2016-17 (check one)
Junior
Senior
Please list your high school activities, community service activities, honors received, and offices
held.
Please list any courses, training or experiences you have completed that will enhance your
qualifications for the Wisconsin Youth Apprenticeship Program.
Please comment on your high school attendance record for the current year if any clarification is
needed.
Revised 1/22/2016
2
YOUTH APPRENTICESHIP TIME COMMITMENT
(June 2016 - May 2017)
I understand that a Youth Apprenticeship requires a time commitment beyond that of a typical high
school student. I will be asked to provide my work site with specific hours and days that I will be
available to work. I understand that timely communication with my work site mentor regarding
changes in my personal schedule is extremely important.
Below is a list of the other extracurricular activities (sports, musicals, band, vacations etc. in which I
currently plan to participate, as well as a summarized timeline for each activity. I am providing as
much information as I have available and being as specific as I possibly can at this time.
ACTIVITY PLANNED
GENERAL TIMEFRAME
(MONTHS)
EXPECTED TIME OF
DAY/HOURS
Example: Football
August through November
Practice M-Th from 3-7pm,
game every Friday
A Youth Apprentice must complete 450 total work hours during the year, which usually includes
summer work scheduling. This means that a typical Youth Apprentice dedicates an average of 10-12
hours per week to their job during the school year, and often more time during the summer.
As a Youth Apprentice, I agree to:
 Maintain the academic and attendance requirements enforced by the Youth Apprenticeship
Partnership, my school and my work site.
 Observe company and school rules and other requirements identified by the employer.
 Participate in progress reviews scheduled with mentors, school personnel and
parents/guardians.
 Understand that if I am hired by an employer, any request I make to switch or transfer places
of employment will not be honored or fulfilled by the YA program unless warranted and
mutually agreed upon by all affected parties.
STUDENT SIGNATURE _________________________________ DATE _____________________
PARENT SIGNATURE __________________________________ DATE _____________________
Revised 1/5/2016
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II. PARENT OR GUARDIAN INFORMATION
Father's Name
Daytime Phone
Mother's Name c Daytime Phone
Guardian's Name
Daytime Phone
Parent E-mail address
If parent address is different than student address, please list the parent address below.
Address
Phone
City
Zip
III. PARENT/GUARDIAN CERTIFICATION AND RELEASEPRINT PAGE and have Parent/guardian initial before each statement, student and
parent/guardian sign below.
I certify that the facts contained in this application are true and complete to the best of my knowledge and
understand that if my student is selected for the Youth Apprenticeship Program, falsified statements may be
grounds for removal.
_____ I certify that my student has a clean driving record and no felony convictions.
_____ I understand that if hired in the Finance program area, the student will be bonded and may be asked
about any criminal background.
_____ I authorize investigation of all statements contained herein and the references listed in this application
and all information concerning previous employers, and release all parties from liability for any
damage that may result from furnishing those to you.
_____ I understand that LTC tuition fees required for related courses will be paid for through the Youth
Apprenticeship grant if my student earns a grade of C or higher, and if a grade below C level is
received then all costs will be the responsibility of the student’s family.
_____ I understand that the student must consult the high school liaison on payment for needed textbooks,
but it is the responsibility of the student to obtain necessary text book prior to the start of the LTC
class
_____ I understand that a parent/guardian must attend, along with my student, any orientation session and
grading conferences that are required for the Youth Apprenticeship Program for which my child
wishes to apply.
_____ I authorize the release of transcripts of grades and attendance records.
_____ I understand that I am solely responsible for the transportation of the undersigned student to and/or
from the classroom or the work site and for all loss involved in said transportation.
_____ I certify that the student has a valid driver’s license and adequate car insurance (necessary only in
those cases where the student will be driving to classroom or work site).
STUDENT SIGNATURE ________________________________ DATE ____________________
PARENT SIGNATURE _________________________________
Revised 1/5/2016
DATE ____________________
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IV. EMPLOYMENT HISTORY- please list previous employment:
1.
Employer's Name
Address
City/ZIP
Work Assignment
Dates of Employment
Phone
Supervisor
Student comments about work responsibilities and learning experience:
2.
Employer's Name
Address
City/ZIP
Work Assignment
Dates of Employment
Phone
Supervisor
Student comments about work responsibilities and learning experience:
Revised 1/5/2016
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V. APPLICANT PROGRAM INTEREST ESSAY
In a typewritten or word processed format, please explain why you feel you should be
selected for the Youth Apprenticeship Program. Do not exceed 250 words. Please include
answers to the following questions:
(a) Why are you interested in the Youth Apprenticeship Program?
(b) How do your career interests relate to the program area for which you are applying?
(c) Why do you think you should be considered as an apprentice?
(d) What is your long-term career goal?
Revised 1/5/2016
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Program Related High School Instructor
Recommendation Form—PRINT PAGE before completing
Return to High School Youth Apprenticeship Liaison in a sealed envelope
Student Name ____________________________ Grade ______ High School________________
Please refer to the checklist below to provide an accurate assessment of the applicant in the
following areas.
No Basis for
Judgement
Below
Average
Average
Above
Average
Excellent
(top 10%)
Academic Performance/Quality of Work
Responsibility
Attitude
Effort
Honesty
Dependability
Teamwork/Cooperation
Problem Solving
Leadership
Attendance
Please provide additional comments on the student's qualifications for this program.
____________________________________
PRINTED NAME OF REFERENCE PERSON
_______________________________________
POSITION/SUBJECT TAUGHT
______________________________________________________
SIGNATURE
_________________
DATE
Return to High School Youth Apprenticeship Liaison in a sealed envelope with your initials
signed on the seal by February 26, 2016 or e-mail to Jackie.holly@gotoltc.edu.
Revised 1/5/2016
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High School Personnel
Counselor, Club Advisor, Coach, Non-Program Teacher
Recommendation Form-PRINT PAGE before completing
Return to High School Youth Apprenticeship Liaison in a sealed envelope
Student Name
Grade ________ High School _____________________
Please refer to the checklist below to provide an accurate assessment of the applicant in the
following areas
No Basis for
Judgement
Below
Average
Average
Above
Average
Excellent
(top 10%)
Academic Performance/Quality of Work
Responsibility
Attitude
Effort
Honesty
Dependability
Teamwork/Cooperation
Problem Solving
Leadership
Attendance
Please provide additional comments on the student's qualifications for this program.
____________________________________
PRINTED NAME OF REFERENCE PERSON
____________________________________
SIGNATURE
________________________________________
POSITION
______________________
DATE
Return to High School Youth Apprenticeship Liaison in a sealed envelope with your initials
signed on the seal by February 26, 2016 or e-mail to Jackie.holly@gotoltc.edu
Revised 1/5/2016
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