Application www.lafellows.org
Thank you for your interest in applying to be an LA Fellow. Please complete all four sections of the application including contact information, short answer, personal statement, and references, and also attach a copy of your resume. Refer to www.lafellows.org
for application deadline information.
Name: _________________________ ____________________________________ _____________
Last First Middle or Initial
Address: ______________________________________________________________
Street
_______________________________ CA _________________
City State
Phone Home: (______)_______-_________
Zip
Cell: (______)_______-_________
E-mail Address: _____________________________ Social Security Number_______________________
Date Attended Orientation: _______________________
Employment Status (Check one): Employed Full Time Employed Part Time
Student Unemployed
If currently employed: Employer__________________________ Job Title__________________________
If not currently employed, who is your last employer and what position did you hold?
______________________________________________________________________________________
How long have you been unemployed or underemployed? __________________
Are you receiving unemployment benefits?
Have you exhausted your unemployment benefits?
What is the reason you are no longer employed? Contract Ended
Resigned
Laid Off
Terminated
Other _______________________
Were you laid off from one of the following companies in the last three years ?
Position Seeking or Job Titles Applying to:______________________________________________
How did you learn about the LA Fellows program? ____________________________________________
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Application www.lafellows.org
If you are currently enrolled in a WorkSource Center, which center are you enrolled with?______________
Case Manager:____________________ Case Manager Contact Info:_______________________________
Have you participated in a training in the last three years?
If yes, which training(s)? _________________________________________________________________
Are you a Veteran?
Gender: ___________________
If yes, what branch? ___________________
DOB: ___________________
Level of Education:
Ethnic Group:
Graduate Degree
White (non-Hispanic) American Indian
Guamanian Korean
Black (non-Hispanic) Alaska Native
Hawaiian
Hispanic
Japanese
Other_______________
Laotian
Filipino
Samoan
Asian Indian
Vietnamese
Cambodian
Asian/Pacific Chinese
Islander
1. Briefly give an overview of your work history (fields, positions, experiences):
2. Have you volunteered in the past? If yes, where, when, how long, and describe your experience?
3. Can you commit to 140 hours of professional training over the course of nine weeks, and 100 hours of volunteer work to complete the requirements for the LA Fellows program?
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Application www.lafellows.org
4. The LA Fellows program is provided to participants at no cost. LA Fellows will participate in unpaid training and unpaid volunteer work. LA Fellows will still be eligible to receive unemployment benefits. Are you able to economically support yourself during the LA Fellows program?
5. An important component of the LA Fellows program is volunteer work that may require a background check and drug testing. Do you anticipate any challenges in this area?
6. Upon acceptance to the program, LA Fellows must complete enrollment forms and requirements at the mandatory orientation. Items needed if applicable : Valid CA ID/License, Social Security Card, or if not a
US citizen, Right-to-Work documents (Valid US Passport or Alien Card); Selective Services (CPC/verify);
Unemployment Insurance Documents (EDD); Lay-off WARN Notice. Do you anticipate any challenges providing this information and documents?
Please submit a one to two page personal statement that provides a clear indication of your professional goals and interests. When writing your personal statement, describe relevant work and volunteer experience and outline your career objectives. Tell us about your job search, what’s working, what’s not working, and how can LA Fellows help you.
If you are selected for the program, what are your expectations of the LA Fellows experience? Tell us why you would like to be an LA Fellow. Be sure to include any other information you think would be helpful to determine your ability to succeed in the LA Fellows program.
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Application www.lafellows.org
Please provide three references in the space below. These references must be nonrelatives who know you in a work or volunteer setting. For each reference under relationship, describe how you know him or her and in what capacity you have worked with each of them. References may be contacted.
Reference 1
Name: ___________________________________________
Phone: (______)___________-_________________
E-mail: __________________________________________
Relationship: ______________________________________________________
Number of years you have known him or her: ________________
Reference 2
Name: ___________________________________________
Phone: (______)___________-_________________
E-mail: __________________________________________
Relationship: ______________________________________________________
Number of years you have known him or her: ________________
Reference 3
Name: ___________________________________________
Phone: (______)___________-_________________
E-mail: __________________________________________
Relationship: ______________________________________________________
Number of years you have known him or her: ________________
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Application www.lafellows.org
Once you have completed all four sections of the application, please attach a copy of your resume and submit via e-mail as a pdf, mail, or in person.
E-mail: info@lafellows.org
Mail: LA Fellows Program/Job Training
Los Angeles Valley College
5800 Fulton Ave.
Valley Glen, CA 91401
818.947.2940 (Please call to make sure we received it) Fax:
In Person: Los Angeles Valley College
Job Training Office (Administration Building)
5800 Fulton Ave.
Valley Glen, CA 91401
After you submit your completed application, you will be eligible for an interview. If you have any questions about the application or the program, contact Allison Silver, Project
Director, at silverag@lavc.edu
or Mary Turner, Project Assistant, at turnerme@lavc.edu
.
Both can be reached at 818.947.2941.
If you have not already attended an orientation, please attend one. Dates, times and locations, and application deadlines can be found on www.lafellows.org
. You are required to attend an orientation in order to be considered for the LA Fellows program.
We look forward to receiving your application.
A Specially Funded Project of Los Angeles Valley College
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