Academic and Career Opportunities

WIA Youth

Personal Profile

Fresno Regional Workforce Investment Board Page 1 of 5 Form# ACA-003, revised 3/25/14

PLEASEHELPUSGETTOKNOWYOUALITTLEBETTER

Personal Information

Name:
Date:
What school are you attending?
What grade are you in?

Education/Training Activities(Out-of-School Youth Only)

Do you have a:
  1. High School Diploma
/ Yes / No
  1. GED
/ Yes / No
  1. Vocational Certificate
/ Yes / No
  1. Other Certificate
/ Yes / No
Do you plan to get your GED? / Yes No
Explain your educational plans:

Issues and Concerns

  • We want to know more about your needs and what might prevent you from meeting your career goals, completing a work experience, or participating in this program.
  • Do any of these issues concern you and is any agency or person helping youdeal with this concern?

Issues / Yes / No / Describe / Assisting Agency/Person
Basic Education Assistance (Math, Reading, GED Classes)
Financial Aid for School
Transportation
Childcare
Financial Services
Food Services
Housing Assistance
Clothing Assistance
Limited English (ESL)
Legal Right to Work

Fresno Regional Workforce Investment Board Page 1 of 5 Form# ACA-003, revised 3/25/14

Personal Summary (Answers will be kept confidential)

Briefly describe how you feel about yourself:
Briefly describe how you think others feel about you:
What do you expect from yourself?
What do you expect from your family?
What do you expect from this Youth Program?

Recreation

What do you enjoy doing in your spare time?
What extra-curricular activities do you participate in? (Sports, School, Clubs, Church, etc.)

Work Experience

Record any jobs and/or volunteer jobs you’ve had below

Name of Employer: / Job Title:
Start Date: / End Date:
Job Duties: / Supervisors Name:
Contact Information:
Name of Employer: / Job Title:
Start Date: / End Date:
Job Duties: / Supervisors Name:
Contact Information:
Name of Employer: / Job Title:
Start Date: / End Date:
Job Duties: / Supervisors Name:
Contact Information:

Personal Career Inventory

What do you see yourself doing in three years?
1.
2.
3.
How do you plan to achieve these goals?
What are your future career goals? (Examples: Teacher, Engineer, Nurse, Mechanic, Accountant)
1.
2.
3.
What are your future educational goals? (Examples: Vocational School, Community College, 4-Yr College)
Do you have a resume? Yes No
Have you ever interviewed for a job? Yes No If yes, how many? ______
Have you ever completed a job application? Yes No If yes, how many? ______
Have you ever had a job? Yes No If yes, how many? ______
Were you successful? Yes No If no, please describe the issues below?

Fresno Regional Workforce Investment Board Page 1 of 5 Form# ACA-003, revised 3/25/14