Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Sign up for Resume Strategies - Online Tuesday, March 21, 2023 10:00 - 11:00 a.m.
If you require accommodations to participate in this class, please contact Tom Grogan at
thomas.grogan@maine.edu
or 207-262-7843.
Thank you for providing the following information. Your name and contact information will not be shared. Aggregate data is used for the purposes of reporting to our funders and measuring the success of our programs.
All fields are required on the registration form. Please contact Tom Grogan at
thomas.grogan@maine.edu
or 207-262-7843 if you prefer a paper copy or have any questions. If you have taken a class with NVME recently, contact the trainer. Your registration information may already be on file.
You may be contacted in the future to provide feedback on your experience with NVME.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name - First
*
Your answer
Name - Middle
Your answer
Name - Last
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Email
*
Your answer
Phone number
*
Your answer
Alternate phone number
Your answer
How did you hear about us?
*
Your answer
Sign me up for the email news about our programs?
*
Yes
No
Required
Gender
Female
Male
Undisclosed
Other:
If you would like the opportunity, we invite you to say more about your gender identity here:
Your answer
If you are of Franco-American heritage, please check here.
*
Yes
No
Unsure
Required
If you consider yourself Hispanic or Latino, please check here.
*
Yes
No
Unsure
Required
In addition, check one or more of the following racial categories to describe yourself.
*
White
Asian
Native Hawaiian or Pacific Islander
Black or African American
Native American or Alaska Native
Other - check here and continue to the next question.
Required
If you chose other above, please list here.
Your answer
Work Status
*
Employed
Employed part-time or seasonal
Unemployed
Self-Employed
Retired/semi-retired
Required
I have a disability that limits my work
*
Yes
No
Required
I receive SSI, SSDI, or veterans disability?
*
Yes
No
Required
I am a veteran, active duty military or reservist
*
Yes
No
Required
I receive unemployment insurance (UI)?
*
Yes
No
Required
I am looking for work
*
Yes
No
Required
Education Information
*
Did not complete high school
High school dimploma/HiSET/GED
College coursework
Trade School certificate
Associates Degree
Bachelors Degree
Post-bacculete coursework
Graduate degree
Other
Required
Are you currently enrolled in school?
*
Yes
No
Required
If you are currently a student, what kind of program are you enrolled in?
HS/HiSET/GED
College prep
Trade School
Associates Degree
Bachelor Degree
Graduate Degree
Major field of study?
Your answer
Are you a University of Maine Augusta student?
*
Yes
No
Number of people in your household including you
*
Your answer
Total monthly Income for your household (from all sources)
*
Your answer
Health Insurance coverage (choose one)
*
Self - if household of one with insurance, select this option
Some members
All household members
No one
Are you the Head of Household?
*
Yes
No
Are you a single parent?
*
Yes
No
My household receives food stamps.
*
Yes
No
My household receives TANF.
*
Yes
No
I have savings.
*
Yes
No
I have retirement savings.
*
Yes
No
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of University of Maine System.
Report Abuse
Forms