La Colaborativa: Community Health Worker Training Program 2027
Welcome to La Colaborativa's 2027 Community Health Worker Training Program Application!
Based on these applications, we will contact participants chosen to proceed in the selection process.
Personal Information
First and Middle Names
Last Name
Phone Number
PLEASE add parenthesis & dashes EX. (123) 456-7891
Email
Date of Birth
How should we contact you?
Phone Call
Text Message
Email
Are you between the ages of 18 and 25?
Yes
No
No, but I will be by January 1st of 2027
Yes, but I will be over 25 y/o by January 1st of 2027
Demographics
Street Address
City
Zip Code
Race
Black or African American
Asian
White
Native American or Alaskan Native
Native Hawaiian or Pacific Islander
Other
Ethnicity
Please select...
Hispanic or Latine
Other
Annual Household Income
0 - $25,520
$25,521- $34,480
$34,481-$43,440
$43,441-$52,400
$52,401 to $61,360
$61,361-$70,320
$70,321 to $79,280
$79,281- $88,240
More than $88,240
Short-answer Application Questions:
Level of Education Received
Less than High School
High school diploma or equivalent
Some college, no degree
Associate’s degree
Bachelor’s degree
Master’s degree
Doctoral or professional degree
If applicable, please upload a copy of your High School diploma or proof of expected graduation date.
What is your Work Authorization Status?
ITIN
Work Authorization
US Citizen Status
Processing
Resident/Green Card
Not Sure
None
As part of the program, we require candidates to be proficient in English. This means that candidates must be able to speak, read, and write in English, without hesitation. Are you fluent in English?
Yes
No
We also require candidates to be proficient in a second language, in addition to English. This will require the ability to speak, read, and write without hesitation in said language. Please mark the language(s) you are fluent in.
English
Spanish
Haitian-Creole
Portuguese
French
Other
If you marked "other", please state the language(s) below.
Our program is available to young adults from the cities of Chelsea, Revere, East Boston, Everett, Lynn, and Malden. Please mark the city in which you live.
Chelsea
Revere
East Boston
Everett
Lynn
Malden
Other
If you marked "other", please state the city below.
Where did you hear about our program?
Social Media
Radio Announcement
Referred by another organization
Referred by family member or friend
Found a program flier
Other
If you marked "other", please let us know where you heard about our program.
How comfortable are you with your computer skills?
Please select...
Not very or at all comfortable using a computer
Comfortable performing google searches, and crafting and sending emails
Comfortable navigating Microsoft Office and Google Workspace
Advanced computer skills
Are you able to commit an estimated 35 hours per week to this program?
Yes
No
Unsure
Long-answer Application Questions
Please answer the following questions in paragraph form (i.e. 1-3 paragraphs)
What are your personal and professional goals? How will this Community Health Worker Training and Certification Opportunity help you achieve these goals?
Share an experience where you served the community. How did this experience help you realize that you are a community-service driven leader?
What area or topic in community health and community service are you particularly passionate about? Why?
Resume Upload
We require that all applicants submit a resume as part of the application process. Please submit your resume below.
If you do not have a resume, please visit our Survival Center's Front Desk (244 Arlington St.) , we are happy to help you build your resume for submission.
This marks the end of the application. Please be on the lookout for communications from us with next steps in the application process.
We look forward to reviewing your application.
Thank you!
Contact Information