Name *

First Name

Last Name

Phone *

(###)

###

####

Are you currently under DJS supervision? *

Yes

No

If you have an approaching court date, would you like to speak with BYA staff about writing a court letter highlighting your participation in the program? *

Yes

No

N/A

Are you a Baltimore City resident? (must show proof of residency to join C.O.R.E.)

Yes

No

Are you 18-25 years old? (if younger than 18, please consider applying to other training program, SAP)

Yes

No

Do you have a resume?

Yes

No

Have you written a cover letter before?

Yes

No

Which of the following identity documents do you have:?

School ID

Driver's License/Gov't ID

Passport

Hospital Record

Which of the following work authorization documents do you have?

Birth Certificate (Copy or Original)

Social Security Card (Copy or Original)

Green Card