Youth Apprenticeship Form

Youth Apprenticeship Program

About the Youth Apprenticeship program

The Tehama County Youth Apprenticeship Program provides students with hands-on experience while partnering with local businesses to enhance mechanics and manufacturing.

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Youth Apprenticeship Form

Basic Information

Please complete all sections. This helps us match you with the right opportunity.

Full Name(Required)

First Last

Email(Required)

Phone Number(Required)

Date of Birth(Required)

Address(Required)

Street Address City State ZIP Code

School Information

High School You Attend(Required)

CTE or Shop Classes You've Taken(Required)

For example: Ag Mechanics, Welding, Auto, Construction, etc.

Have you taken any college (dual enrollment) classes?(Required)

Yes

If yes, list them(Required)

Experience & Background

Are you currently employed?(Required)

Yes

Have you ever worked in this type of field or something similar?(Required)

Yes

If yes, what kind of work and where?(Required)

Previous Work Experience

List your most recent job first. You can include part-time jobs, helping family, or volunteer work. If you do not have all the details, fill in what you can.

Work Experience(Required)

Employer (Name & City)

Supervisor Name

Employer Phone

Job Title

Dates Worked

Why You Left

OK to Contact?

3 References

Professional Reference

Coach, employer, mentor, etc.

Professional Reference - Name(Required)

Professional Reference - Role(Required)

Professional Reference - Phone(Required)

Professional Reference - Relationship(Required)

Personal Reference

Personal Reference - Name(Required)

Personal Reference - Role(Required)

Personal Reference - Phone(Required)

Personal Reference - Relationship(Required)

Teacher Reference

Teacher Reference - Name(Required)

Teacher Reference - School(Required)

Resume Upload

Upload Your Resume

Accepted file types: pdf, png, jpg, docx, Max. file size: 25 MB.

Work Availability & Location

Worksites will be throughout Tehama County and surrounding areas. Given your personal transportation, where are you able to work on a regular basis? (Check all that apply)

Locations you can work(Required)

Red Bluff

Corning

Los Molinos

Cottonwood

Gerber/Vina

Artois

Other

Other location(Required)

Transportation

How will you get to your work site? (Check all that apply). This program requires reliable transportation to work.

Transportation method(Required)

I will drive myself (requires proof of driver license and valid insurance)

Parent/Guardian will drive me

I will bike

I will walk

Public transportation

Other

Other transportation(Required)

Program Expectations

If selected, will you have reliable and consistent transportation to and from work?(Required)

Yes

Are you able to pass a pre-employment drug screening (including THC/marijuana), if required?(Required)

Yes

Are you willing to follow all workplace safety rules, including wearing required safety gear (PPE)?(Required)

Yes

Are you able to perform the basic duties of this program (such as standing for periods of time and lifting up to 25 lbs), with or without reasonable accommodation?(Required)

Yes

Are you legally allowed to work in the United States (documentation will be required if selected)?(Required)

Yes

Schedule & Commitments

Do you have responsibilities outside of school that could affect your work schedule (sports, job, etc.)?(Required)

Yes

If yes, please explain(Required)

Interest in the Program

Why are you interested in the Industrial Mechanic Trainee Program?(Required)

Have you used tools, machines, or mechanical equipment before?(Required)

Yes

If yes, describe your experience(Required)

Your Goals

What do you hope to gain from this program? (Check all that apply)(Required)

Work experience

Job skills

Career exploration

Pathway into a trade or apprenticeship

Other

Other goal(Required)

Are you interested in growing a career in the local area?(Required)

Yes

After high school are you interested in working full-time?(Required)

Yes

Student Certification & Agreement

I certify that the information I have provided is true and complete to the best of my knowledge.

Providing false or incomplete information may affect my participation in the program
This program includes both educational and workplace expectations that I agree to follow
Participation in this program does not guarantee employment
I may be asked to provide additional information (such as school records or references) as part of the application process

I give permission for program staff to contact my references, school, and previous employers (if listed) for purposes related to this application.

I certify and agree to the statements above(Required)

I certify that the information provided is true and complete and I agree to the statements above.

Student Signature (type your full name)(Required)

Date(Required)

Parent/Guardian Signature (required if under 18, type full name)(Required)

Parent/Guardian Date(Required)

Youth Apprenticeship Form

Basic Information

Please complete all sections. This helps us match you with the right opportunity.

Full Name(Required)

First Last

Email(Required)

Phone Number(Required)

Date of Birth(Required)

Address(Required)

Street Address City State ZIP Code

School Information

High School You Attend(Required)

CTE or Shop Classes You've Taken(Required)

For example: Ag Mechanics, Welding, Auto, Construction, etc.

Have you taken any college (dual enrollment) classes?(Required)

Yes

If yes, list them(Required)

Experience & Background

Are you currently employed?(Required)

Yes

Have you ever worked in this type of field or something similar?(Required)

Yes

If yes, what kind of work and where?(Required)

Previous Work Experience

List your most recent job first. You can include part-time jobs, helping family, or volunteer work. If you do not have all the details, fill in what you can.

Work Experience(Required)

Employer (Name & City)

Supervisor Name

Employer Phone

Job Title

Dates Worked

Why You Left

OK to Contact?

3 References

Professional Reference

Coach, employer, mentor, etc.

Professional Reference - Name(Required)

Professional Reference - Role(Required)

Professional Reference - Phone(Required)

Professional Reference - Relationship(Required)

Personal Reference

Personal Reference - Name(Required)

Personal Reference - Role(Required)

Personal Reference - Phone(Required)

Personal Reference - Relationship(Required)

Teacher Reference

Teacher Reference - Name(Required)

Teacher Reference - School(Required)

Resume Upload

Upload Your Resume

Accepted file types: pdf, png, jpg, docx, Max. file size: 25 MB.

Work Availability & Location

Worksites will be throughout Tehama County and surrounding areas. Given your personal transportation, where are you able to work on a regular basis? (Check all that apply)

Locations you can work(Required)

Red Bluff

Corning

Los Molinos

Cottonwood

Gerber/Vina

Artois

Other

Other location(Required)

Transportation

How will you get to your work site? (Check all that apply). This program requires reliable transportation to work.

Transportation method(Required)

I will drive myself (requires proof of driver license and valid insurance)

Parent/Guardian will drive me

I will bike

I will walk

Public transportation

Other

Other transportation(Required)

Program Expectations

If selected, will you have reliable and consistent transportation to and from work?(Required)

Yes

Are you able to pass a pre-employment drug screening (including THC/marijuana), if required?(Required)

Yes

Are you willing to follow all workplace safety rules, including wearing required safety gear (PPE)?(Required)

Yes

Are you able to perform the basic duties of this program (such as standing for periods of time and lifting up to 25 lbs), with or without reasonable accommodation?(Required)

Yes

Are you legally allowed to work in the United States (documentation will be required if selected)?(Required)

Yes

Schedule & Commitments

Do you have responsibilities outside of school that could affect your work schedule (sports, job, etc.)?(Required)

Yes

If yes, please explain(Required)

Interest in the Program

Why are you interested in the Industrial Mechanic Trainee Program?(Required)

Have you used tools, machines, or mechanical equipment before?(Required)

Yes

If yes, describe your experience(Required)

Your Goals

What do you hope to gain from this program? (Check all that apply)(Required)

Work experience

Job skills

Career exploration

Pathway into a trade or apprenticeship

Other

Other goal(Required)

Are you interested in growing a career in the local area?(Required)

Yes

After high school are you interested in working full-time?(Required)

Yes

Student Certification & Agreement

I certify that the information I have provided is true and complete to the best of my knowledge.

Providing false or incomplete information may affect my participation in the program
This program includes both educational and workplace expectations that I agree to follow
Participation in this program does not guarantee employment
I may be asked to provide additional information (such as school records or references) as part of the application process

I give permission for program staff to contact my references, school, and previous employers (if listed) for purposes related to this application.

I certify and agree to the statements above(Required)

I certify that the information provided is true and complete and I agree to the statements above.

Student Signature (type your full name)(Required)

Date(Required)

Parent/Guardian Signature (required if under 18, type full name)(Required)

Parent/Guardian Date(Required)