LEAP Pre-Application

If you're an eligible teen or young adult between the ages of 14 and 24, you can gain:

On-the-Job Training
Entrepreneurial Training
Financial Literacy Guidance
Paid Internships (Ages 16-24)
Life-Skills Training
GED Program Support
One-on-One Career Coaching
Certification Programs and College Education Opportunities

Apply Below!

What if I do not have a computer at home?
If you do not have access to a computer at home, use a computer lab at a public library or contact us to use one of our computers.

How many hours can I work? What times will I work?
Participants can work up to 40 hours/week in compliance with Child Labor Laws. The exact times can be negotiated with supervisors.

When will I be contacted after submitting my information?
A CareerSource Capital Region representative will contact you within two business days of your submission.

Pre-Apply Here!

* Required field

Thank you for your interest in the LEAP. To help us expedite your application please complete the form below. If you have any problems completing the form or if you would like to apply in person please call (850) 922-0023 or email LEAP (Learn, Earn & Advance Program) .

Disclaimer

Current program participants need not reapply. Please contact your LEAP Specialist regarding your interest in continued participation in the program.

First Name *

Last Name *

Middle Initial

Social Security #

Please use this format XXX-XX-XXXX

Disclosure of your social security number is voluntary. It is requested however, pursuant to Privacy Act of 1974. Social security numbers will be used by CareerSource Capital Region for the sole purpose of system review to determine our overall level of efficiency.

Legal Guardian Name (if under 18)

First Name

Last Name

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Contact Information

Address

Street Address

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

County *

Gadsden
Jefferson
Leon
Wakulla

Email *

Cell Phone or Home Phone *

Area Code

Phone Number

Alternate Contact Number

Area Code

Phone Number

What is your primary language?

English
Spanish
Other

What type of career are you most interested in?

How Did You Hear About This Program?

If applicable, which organization referred you to this Pre-Application or the LEAP program?

Please complete the following questions to help us determine your potential eligibility for the LEAP program. The more accurate the information you provide, the easier it will be for us to enroll you in our program. All of the information collected is confidential.

Are you between the ages of 14 and 24 years old? *

What is the highest level of education that you have achieved? *

Which of the following sentences best describe your current situation? SELECT ALL THAT APPLY (Hold the *

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