2025 IYIP -- Interest Form

2025 IYIP -- Prospective Young Adult Participant

To Be Completed By Prospective Young Adult Participant
The Kindness Campaign is recruiting eligibleyoung adults ages 16 – 24 to participate in a youth career pathway opportunity. IYIP is a multi-faceted approach to young adult employment that invests in the future of Illinois’ young adults.

Requirements

- Ages 16 – 24

- Possess A Valid Government Issued Photo ID

- Must Have And Be Able To Prove US Work Authorization

- Must Be actively Seeking Employment or Career Growth/Change

- Must Be Willing To Cooperate With All Program Requirements

- Must Reside In One of The Following Zip Codes: 60619, 60620, 60621, 60628, 60636, 60637, 60643 or 60649
About The Prospective Young Adult
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Date of Birth*

MonthDayYear
Date of Birth As MM/DD/YYYY
Gender Identity*

Male (Boy)Female (Girl)Non-ConformingDo Not Wish To Answer
Please Select What Best Describes Your Current Status (Please Check One):*

Young Adult That Is Not In School But Seeking Employment or TrainingYoung Adult Currently Working But Looking For Career Growth/ChangeYoung Adult That Is Heading Back To College When It StartsYoung Adult That Is Heading Back To High School When It StartsYoung Adult That Recently Completed High School And Is Unsure of FutureNone Of The Above Applies To Me
What is your highest level of education completed?*

High School Diploma/GEDSome College Courses CompletedCompleted A Vocational or Career Training ProgramCompleted College And Obtained a 2-Year or 4-Year DegreeDid Not Complete High School/GEDOther
Are you currently employed?*

YesNo
Do you have a valid, government issued photo ID?*

YesNo
Do you have documents to show that you have US work authorization such as a social security card, birth certificate of passport?*

YesNo
Do you have a valid state issued driver's license?*

YesNo
Do you have your own automobile (car)?*

YesNo
Are you currently homeless?*

YesNo
Do you require any accommodations related to a disability or disabling condition to work?*

YesNo
Have you been convicted of a crime (felony or misdemeanor)?*

YesNo
Do you have any pending criminal cases?*

YesNo
Do You Have A Personal Computer (PC) or Laptop At Home?*

YesNo
Do you know the password to your email account?*

YesNo
What is your transportation source for work?*

I Drive Myself In My Personal VehicleI Drive Myself In Someone Else's VehicleI Get Rides From Someone With A VehicleI Ride Public TransportationI Use Rideshare (Uber/Lyft) To Get AroundOther/Not Listed
Please Tell Us About Yourself. You May Share Anything About Yourself. *
Please Complete This Section If You Are Under 18 Years of Age
Parent/Guardian Name

First NameLast Name
Parent/Guardian Phone
Please enter a valid phone number.
Parent/Guardian Email Address
example@example.com
Young Adult Signature*

Clear
Today's Date*

MonthDayYear
Date
Should be Empty:

2025 IYIP -- Prospective Young Adult Participant

About The Prospective Young Adult

Please Complete This Section If You Are Under 18 Years of Age