Adult Culinary Program Application

Contact Information

Name *

First

Last Name *

Last

Birthday

Email

Phone

Address

City

State/Province

Zip/Postal

Work Experience

In a few short sentences, please tell us what brings you to Riverview Gardens and what are your goals for future employment?

Are you currently employed? If so, what is the name of your employer, your current wage, and the number of hours you work each week?

What kind of jobs have you had in the past? Please share some of your work history, including any kitchen or restaurant experience.

What (if any) barriers do you face in maintaining stable employment?

Education Background

Highest Level Completed

Demographic Information

Gender

Male

Female

Other

Prefer not to say

Preferred Pronouns

He/Him/His

She/Her/Hers

They/Them/Theirs

Other

Race / Ethnicity

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White

Two or More Races

Prefer not to say

Have you ever served on active duty with the U.S. Military, National Guard, or Reserves?

Yes

No

Do you have any foodborne allergies? *

Yes

No

Describe Allergies

Do you have any disabilities? *

Yes

No

Describe disabilities:

How did you hear about us?

Emergency Contact

Name *

First

Last Name *

Last

Phone Number *

Program Requirements

I am 18+ years of age.

I experience barriers to employment and/or are considered low income.

I am available to train for up to 6 hours a day, Monday through Thursday.

I can work in the U.S. and have valid identification for employment.