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Application for Workforce Services


  1. 1. Applicant Information
  2. 2. Employment Information
  3. 3. Household & Income Information
  4. 4. Disclaimer & Signature
  5. 5. Optional Equal Opportunity Survey Form
  • Applicant Information

    1. How did you hear about us?
    2. (example: Goodwill, Vocational Rehabilitation, etc.)
    3. Alternate Contacts
      Please provide contact information for 2 other individuals who can always contact you. In the case that we cannot reach you, we may contact them in our attempts to contact you.
    4. Are you registered with Selective Service (the Draft)?
      This applies only to males born after 1960.
    5. Have you or your spouse ever served in the military?
    6. Who?
    7. Has your family recently relocated as the result of military relocation / change of duty station?
    8. In the past 24 months, have you earned more than half your wages or spent more than half of your time working in farm or agricultural related work?
    9. Have you ever been or are you currently in the foster care system?
    10. Do you have your diploma or GED?
    11. Are you currently in school?
    12. Do you have any other certifications or credentials?