Youth Pathways Application
Applying for a Youth Apprentice position with Bikes Not Bombs
Which cohort are you applying for? Summer Applications are open until July 1st, 2024
Please select...
Summer Cohort - Applications Open
1. Applicant Personal Information
Legal Name:
First Name:
Last Name:
Middle Name:
Address (street):
City:
State:
ZIP Code:
Home Phone #:
Cell Phone #:
Other Phone #:
Neighborhood you live in:
Please select...
Dorchester
Mattapan
Roxbury
Other
Email:
Birthdate:
Gender:
Please select...
Male
Female
Non-Binary
Trans
Prefer Not To Say
Pronouns
Race/Ethnicity:
Please select...
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Latino
Multiracial
Languages Spoken:
Do you identify as a member of the LGBTQ+ community? (Optional)
Please select...
Yes
No
Do you identify as neurodivergent and/or have a disability? (Optional)
Please select...
Yes
No
Emergency Contact #1 (Must be parent/legal guardian if under 18)
Emergency Contact Name:
Relationship to you:
Address
Home Phone #:
Cell Phone #:
Email:
Emergency Contact #2
Emergency Contact Name:
Relationship to you:
Address
Home Phone #:
Cell Phone #:
Email:
2. Education Information
Name of School/GED Program:
School Address:
Name of Guidance Counselor:
Grade:
Please select...
6
7
8
9
10
11
12
Vocational Training
College
Not in School
3. Medical Information
Illnesses: (If none, type "N/A")
Dietary Restrictions: (If none, type "N/A")
Allergies:
(If none, type "N/A")
Injuries:
(If none, type "N/A")
Medications:
(If none, type "N/A")
Physical Limitations:
(If none, type "N/A")
Name of Health Care Provider:
Health Card/Policy #:
Clinic/Hospital:
Clinic/Hospital Phone #:
Physician's Name:
Physician's Phone #:
4. Availability
What is your regular school dismissal time? Is it the same daily?
Please list all other obligations you have this season (other jobs, clubs, activities, sports, baby-sitting, school trips, and anything else that may affect your work schedule. Please remember that programs run Monday through Friday from 1:30 - 6:30 PM. Occasional Saturdays and other times based on programs.
Rank by preference the days you wish to work, with 1 being "least favorite" and 5 being "most favorite":
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
5. Experience
On a scale of 1-5, rate your level of confidence in the following areas (1 being not at all confident and 5 being highly confident). This information will be used to design instructor training and development.
Mechanics
Group riding
Teaching lessons to a group
Teaching lessons one-on-one
Enforcing and following BNB rules
Explaining and representing BNB's mission to others
6. Materials
For group rides, I plan to use:
Please select...
A BNB bike
My own bike
If you answered "A BNB bike," do you own a bike that you could use if it were repaired?
Please select...
Yes
No
What is your height?
7. Questionnaire
Have you completed a Bike School program?
Yes
No
If yes, what Bike School class did you take?
How did you hear about this program?
Why do you want to enroll in this program?
8. Reflection
What is one success that you have had at Bikes Not Bombs or in another part of your life? What made it a success? How did you obtain it? Your answer can be related to something you learned, a personal goal, or any experience you feel is related.
Describe a goal that you will set for yourself if hired as a youth instructor/organizer at Bikes Not Bombs. What skills, knowledge, or resources will you need in order to obtain this goal?
Contact Information