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2. First Name*
3. Last Name*
5. Date of Birth*

   Example: 03/08/2008

6. GPA*

   Number only. Example: 3.6

8. Current Grade Level*
   -- Select One --9th10th11th12th
9. School*
   -- Select One --Dallas Christian AcademyHorn High SchoolIgnite Community SchoolLegacy Prep Charter SchoolMesquite AcademyMesquite High SchoolNorth Mesquite High SchoolPioneer Technology & Arts AcademyPoteet High SchoolVanguard High SchoolWest Mesquite High SchoolHomeschoolOther - my school is not listed
11. Ethnicity*
    -- Select One --HispanicNon-HispanicPrefer not to respond
12. Race*
    -- Select One --American Indian or Alaska NativeAmerican Indian or Alaska Native and WhiteAmerican Indian or Alaska Native and BlackAsianAsian and WhiteBlack/African AmericanBlack/African American and WhiteNative Hawaiian or Other Pacific IslanderWhiteOther multi-racialPrefer not to respond
14. Gender*
    -- Select One --FemaleMaleNon-BinaryPrefer not to respond
16. Email Address*

    Provide the email address you check most frequently. This is the email address application updates will be sent to.

17. Mobile Phone Number*

    Example: 478-236-1548

19. Address1*
21. Address2
23. City*
24. State*
    -- Select One --Texas
25. Zip*
29. Parent/Guardian First Name*
30. Parent/Guardian Last Name*
32. Parent/Guardian Email Address*
33. Parent/Guardian Mobile Phone Number*

    Example: 478-236-1548

35. Parent/Guardian Address1*
37. Parent/Guardian Address2
39. Parent/Guardian City*
40. Parent/Guardian State*
    -- Select One --Texas
41. Parent/Guardian Zip*
45. Do you live in the City of Mesquite?*
    -- Select One --YesNo
47. Will you be at least 16 years of age by June 1, 2025?*
    -- Select One --YesNo
49. Are you able to work June 9 - July 18 with 3 or fewer known absences?*
    -- Select One --YesNo
51. Are you able to be scheduled to work for 20 hours per week?*
    -- Select One --YesNo
53. Are you available to work weekends?*
    -- Select One --YesNo
55. Are you a US Citizen or lawfully authorized to work in the U.S.?*
    -- Select One --YesNo
57. Will you have reliable transportation to and from your job site?*
    -- Select One --YesNo
59. Are you related to a city employee, elected official, or any board member?*
    -- Select One --YesNo
61. If yes, name of relative and relationship to relative.
63. How did you hear about the Summer Youth Internship Program?*
    -- Select One --TeacherTeacher nomination formSchool employee other than teacherFriendFamilySocial Media - City of MesquiteSocial Media - SchoolSocial Media - MISDClassroom or club visit from Mesquite Youth ServicesFlyerCity of Mesquite WebpageOther
65. What is your t-shirt size?*
    -- Select One --X-SmallSmallMediumLargeX-LargeXX-Large
69. Short Answer Question #1 - 999 character limit*

    What do you hope to gain from this internship experience?

71. Short Answer Question #2 - 999 character limit*

    What skills, hobbies, work experience, or qualities make you a strong candidate for this opportunity?

75. Household Information

    You must include everyone living in the household regardless of age to satisfy grant requirements.

    Provide: First & last name, date of birth, relationship to applicant, and occupation

    Example: Ace Sanchez, 02/17/2002, brother, student

77. How many members live in your household including yourself?*
    -- Select One --12345678> 8
79. Household Member #1 (Applicant)*
81. Household Member #2
83. Household Member #3
85. Household Member #4
87. Household Member #5
89. Household Member #6
91. Household Member #7
93. Household Member #8
97. Describe what career areas best align with your interest. Please select all that you are open to.*

    1. Government & Public Service (e.g., City Hall, community outreach & programs)
    2. Arts, Media & Communication (e.g., graphic design, social media, writing blogs, newsletters, photography)
    3. Science, Engineering & Math (STEM) (e.g., labs, research, engineering, conduct studies, data collection, and surveys)
    4. Business, Marketing & Entrepreneurship (e.g., sales, finance, marketing, small business operations, and customer service)
    5. Environmental & Agricultural Studies (e.g., sustainability, parks, gardening)
    6. Healthcare & Human Services (e.g., hospitals, physical therapy, counseling, wellness)
    7. Trades & Skilled Labor (e.g., construction, automotive, electrical)
    8. Law, Criminal Justice & Public Safety (e.g., law enforcement, legal studies)
    9. Sports, Recreation & Fitness (e.g., coaching, athletic training, event planning)
    10. Hospitality, Tourism & Culinary Arts (e.g., restaurants, hotels, event planning, city-planning)
    11. Education & Youth Development (e.g., tutoring, camps, after-school programs, activities with kids)
    12. Animal Care & Veterinary Science (e.g., shelters, vet clinics)
    13. Leadership, Advocacy & Community Engagement (e.g., non-profits, city initiatives, fundraising, event coordination)
    14. Media, Journalism & Content Creation (e.g., photography, videography, writing, newsletters, social media, blog management)
101. Letter of Recommendation*

     Letter of recommendation must:

     1. be from a non-family member (principal, counselor, teacher, coach, mentor, community member, etc.). 
     2. have the name, email address, job title,  employer, and signature of the recommender.
     3. be no more than one page in length
     4. be uploaded as a .pdf 
103. Official Transcript*

     Provide your official high school transcript; must be uploaded as a .pdf file. 

     [At MISD schools, official transcripts can be obtained from the counseling teams]

105. Social Security Card or Work Authorization Document*
107. Parent/Guardian Photo ID*
109. Proof of Residency*

     Example: current utility bill

111. Proof of Applicant Age

     Example: birth certificate, state issued ID, Driver’s License, passport, etc

     If your school’s official transcript includes your date of birth, you do not need to provide an additional proof of age document

115. Provide 2 consecutive paystubs for anyone living in the household over the age of 18

     If unemployed, must provide a benefit award letter or complete an unemployment affidavit (email Sheridan Hodges, shodges@cityofmesquite.com to request the form) 

     If no income, parents must submit an affidavit certifying zero income (email Sheridan Hodges, shodges@cityofmesquite.com to request the form) 

     Note: if a household member is enrolled in school part-time or full-time, proof of enrollment can be provided in lieu of paystubs.

117. 1. Household Member over 18 - Paystub #1*
119. 1. Household Member over 18 - Paystub #2
121. 2. Household Member over 18 - Paystub #1
123. 2. Household Member over 18 - Paystub #2
125. 3. Household Member over 18 - Paystub #1
127. 3. Household Member over 18 - Paystub #2
129. 4. Household Member over 18 - Paystub #1
131. 4. Household Member over 18 - Paystub #2
Leave This Blank:


133. 1. Receive an email copy of this form.
134. Email address

     This field is not part of the form submission.

135. Submit

* indicates a required field