Personal Data

Work Preference

Additional Information

IMPORTANT: In answering the following questions, include offenses or charges to which a guilty or nolo contendere plea was entered or, if convicted, a sentence if probation was imposed. The fact that you are awaiting trail and/or have a record of conviction will not necessarily bar you from employment, but will be considered in the context of the entire application and position applied for. Failure to answer or answer truthfully shall invalidate employment consideration.

Must be at least 21 for employment consideration.

If you are not sure if you have had violations within the past 3 years, please note so at the bottom of this section, rather than responding "No". Ability to be insured by LCYDC insurance carrier is a requirement for most positions.

Employment Experience

Please list all employment within the past 10 years, starting with most recent. Please include temporary & volunteer work.

Add More Employment Experience

Military Experience


Include all periods of schooling beginning with High School:

Add More Education History

Activities, Licenses, & Special Skills

Please list school, professional, and/or community service. (If you wish, you may omit any organization or activity, the name of which indicates race, sex, color, religion, or national origin of its members.)

Add More Organizations


List three people (one professional, two personal) who aren’t already mentioned in the Employment section whom you have known for at least two years.


An Equal Opportunity Employer: Discrimination against any individual because of race, sex, color, religion, national origin, age, ethnicity, disability status, or status as a veteran or disabled veteran, is prohibited. The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals at least 40 years of age. If you believe you have been discriminated against, you may notify the Equal Employment Opportunity Commission, the Federal Communications Commission, the Office of Federal Contract Compliance Programs or other appropriate federal or state agencies.

Please read carefully. As an applicant, you agree to and understand the following:

  1. You must satisfy the requirements of our post-offer drug screening process.
  2. You must satisfy the requirements of our post-offer evaluation process.
  3. You must execute and agree to abide by the agency’s Arbitration Agreement.
  4. You must provide proof of identity and authorization to work in the U. S. as required by the Immigration Reform and Control Act of 1986.
  5. You will be required to meet the minimum age requirements of applicable laws.
  6. I understand that nothing in this employment application, or in LCYDC’s personnel guidelines, handbooks, policies or procedures is intended to create, or does create, any employment contract between the Center and me. I understand that if I am hired by LCYDC, my employment shall be at-will and I may resign or be terminated at any time for any reason.
  7. If you have signed an employment agreement, confidentiality agreement or any other document with a prior employer that might restrict your activities if hired by LCYDC, you must disclose this fact before a job offer is made. Failure to disclose such information may lead to termination of your employment.
  8. I understand and agree that if hired by LCYDC, my employment may be terminated if subsequent to my hiring, the Youth Development Center becomes aware that I have falsified or misled the Center regarding any information provided on this application or during the application process.
  9. I understand and agree that my agreement to arbitrate any employment dispute pursuant to the provisions of the Lee County Youth Development Center’s Dispute Resolution Program, including but not limited to claims related to my application for employment, and my signature to the Arbitration Agreement provided by LCYDC is a requirement for consideration for employment with LCYDC. I understand that LCYDC will not consider my application unless and until it receives the signed Arbitration Agreement.