YES to the Future – Responsibility Contract

Enrollment Information
Date of Enrollment*
MM slash DD slash YYYY
Career Counselor
Contact Information
Name*
First Last
Participant ID*
Address*
Street Address Address Line 2 City State ZIP Code
County*
Birth Date*
MM slash DD slash YYYY
Primary Phone*
Alternate Phone
Email*
Emergency Contact Information
Name*
First Last
Relationship*
Address*
Street Address Address Line 2 City State ZIP Code
Primary Phone*
Alternate Phone
Name*
First Last
Relationship*
Address*
Street Address Address Line 2 City State ZIP Code
Primary Phone*
Alternate Phone
Mutual Responsibility Contract

My Responsibilities

I understand that I am responsible for the accomplishment of my goals. To be successful, I will:
- Be responsible
- Be accountable
- Respect myself and others
- Work to the best of my ability
- Treat my participation as my job until I can secure employment or enter post-secondary training
- Maintain open communication with my career counselor
- Talk with my career counselor about my interests, goals and ideas for my future
- Attend all program activities and keep scheduled appointments
- Come to program activities with an open mind and ready to learn
- Practice skills that employers are looking for on the job
- Create a plan to follow-up with my career counselor for at least 12 months after I get a job, start training, or enter the military to let them know how I am progressing with my transition and also to let him/her know about additional support I may need
Career Counselor Responsibilities

As your career counselor, I will support your education and career goals. To be successful, I will:
- Be responsible, be accountable, and be respectful
- Provide you with activities to help you explore careers, gain work experience and develop plans to reach your goals.
- Help you understand PA CareerLink® resources and how to access them
- Connect you to others in the community that can help you meet your goals
- Provide allowable supportive services
- Meet with you at least monthly, and more as needed, to help you define your goals, stay on track towards meeting your goals, and being successful
- Be honest and hold you accountable to program expectations
- Stay in contact with you for at least 12 months after you start a job, start training, or enter the military to help you transition successfully and access supports you may need
Career Counselor Signature
Date
MM slash DD slash YYYY
Participant Signature*
Date*
MM slash DD slash YYYY
Parent/Guardian Signature*
Date*
MM slash DD slash YYYY

YES to the Future – Responsibility Contract

Enrollment Information

Contact Information

Emergency Contact Information

Mutual Responsibility Contract