Profile Form

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* 1. What is your First Name?

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* 2. What is your Last Name?

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* 3. What is your Phone Number? (xxxxxxxxxx)

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* 4. What is your Email Address? (_________@______.___)

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* 5. What is your Home Address ( You Must live within a 10 Mile radius of our warehouse located at 1133 Wilso Drive Baltimore MD 21223 to qualify for our program )

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* 6. How did you hear about the 4MyCiTy U! - Job Training and Mentoring Program?

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* 7. What is your current Household Income level? 

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* 8. Which ethnicity best describes you? 

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* 9. How many members are there in your household?

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* 10. What is your age range?

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* 11. What is your current means of transportation?

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* 12. I understand that 4MyCiTy U! - Job Training and Mentoring Program is an at will program administered by the 4MyCiTy Inc. leadership team. This program is solely based on funding availability and can be terminated at anytime with little or no advanced notice. All participants in this program will be paid a base hourly rate of $15.00 per hour and work no more than 20 hours per week at any given time. This program is a 5 Week training Program, with participants expected to complete a minimum of 80 working hours to be considered for graduation.

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* 13. I agree and Understand that 4MyCiTy Inc. Is a nonprofit organization and is doing this service Free of charge to me and or my family on a voluntary basis. This program is not a guaranteed program and can end at anytime without notice. 4MyCiTy does not guarantee future employment through this program for any participants. 4MyCiTy leadership will work with participants of this program to successfully achieve the overall goals outlined, which is to provide a path to future employment opportunities with some of our selected community business partners.

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