Summer Youth Participant Survey

You may also visit www.kansasworks.com for a list of local Kansas Works offices as well as to register and job search on Kansas Works.

 

First Name Last Name Address City / State / Zip Kansas Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Primary Phone Alt. Phone Email Address Birth Date (MM/DD/YYYY) Current Year in School Currently Employed? Yes No How many hours per week would you like to work this summer?