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Center for Workforce Excellence (CfWE)
Participant Registration Form
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* Indicates required question
Email
*
Your email
Last Name:
*
Your answer
First Name:
*
Your answer
Middle Initial:
Your answer
Date of Birth:
*
MM
/
DD
/
YYYY
Are you between the ages of 16-24?
*
Yes
No
Gender:
*
Male
Female
Trans male
Trans female
Prefer not to disclose
I do not know
Other:
Race (check all that apply):
*
Alaska Native/American Indian
Asian/Hmong
Black/African-American
Hawaiian/Other Pacific Islander
White/Caucasian
Multi-racial
Other
Prefer not to disclose
I do not know/other
Other:
Do you identify as Hispanic/Latino?:
*
Yes
No
Do not want to identify
Primary Language:
*
English
Spanish
Other:
Citizenship Status:
Mark only one oval
*
Refugee
Asylum
US Citizen
US Resident
Other:
Cell Phone Number:
*
Your answer
Physical Address (street, city, state, zip):
*
Your answer
Mailing Address:
*
Same as physical address
Other:
Required
Preferred Contact Method:
*
Phone
Email
Text
Required
Veteran Status (Military Service):
*
Currently Enlisted
Veteran
Non-Veteran
Housing Status:
*
Stable Housing
Homeless
Near Homelessness
Shelter (temporary)
Hotel/Motel (temporary)
Friends/Family (temporary)
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