2024 S@CH Application

Application Due Friday, April 19, 2024

A program collaborative between the City of Sacramento Department of Youth, Parks, & Community Enrichment - Youth Division, Natomas Unified School District, Sacramento City Unified School District & Twin Rivers Unified School District.

Student Information

Address

Address or Location

Phone Number

Birthdate

Email: [It is important that you provide us with an active email as you will be contacted by email.]

School District

Current School Attending

Current Grade Level

I identify my ethnicity as:

I identify my gender as:

Parent/Guardian Contact Information

Relationship to Applicant

Email (Must be different from student’s email.)

Home/Cell/Work Phone

Relationship to Applicant

Home/Cell/Work Phone

Email (Must be different from student’s email.)

Work/Volunteer Experience and/or Community Service

Name of Organization/Employer or Supervisor

Type of work:

Describe your duties:

Start Date

End Date

Name of Organization/Employer or Supervisor

Type of work:

Describe your duties:

Start Date

End Date

School Activities, Athletics, or Extra-curricular Activities

Club/Sports/Activity Name

Position

Explain your involvement in the club/sport/activity

Club/Sports/Activity Name

Position

Explain your involvement in the club/sport/activity

References

Relationship to Applicant

Cell/Work Phone

Relationship to Applicant

Cell/Work Phone

Please Answer the Following Questions

Why are you a good candidate for the 2024 Summer @ City Hall program?

Tell us about a local issue or problem in your community that you are concerned about. (Examples: homelessness, education, violence, housing, access to technology, jobs, food access, etc.) Have you thought about a solution for this problem?

Tell us about a challenge or conflict you have faced, and how you were able to overcome it.

I understand that there will be an interview that I am required to attend as part of the selection process.

If selected, I understand that I will be required to attend a mandatory Student Orientation on Saturday, June 15, 2024.

If selected, I commit to attending the program in its entirety, including the full five week of programming, presenting to the City Council, and attending graduation.

If selected, I understand that program is Monday thru Thursday, 9:00 AM–2:00 PM

If selected, I understand that I am required to complete 25 internship hours.

The City of Sacramento complies with the Americans with disabilities Act (ADA) which solely prohibits the discrimination of programs, service, and activities for individuals with disabilities. Would you require any specific or special accommodations. If yes, staff will contact you directly to be sure program needs are met.

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First Name

Last Name

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By signing, I certify that all information in my application is true, complete, and correct.