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BLOC Foundation Eligibility Questionnaire II
Eligibility Questionnaire
* Indicates required question
Email
*
Record my email address with my response
Name
*
Your answer
Email
*
Your answer
Street address
*
Your answer
Apt #
*
Your answer
City
*
Your answer
State
*
Your answer
Zip code
*
Your answer
Phone number
Your answer
Sex
Male
Female
LGBTQIA
Prefer not to say
Can you commit to 12 weeks training program? (Mandatory Requirement)
*
Yes
No
Required
Are you interested in obtaining full time work in the construction industry?
Yes
No
Are you a veteran?
Yes
No
Race
(Please select one):
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Other:
Highest Level of Education
(Please select one):
Some High School
High School Diploma or GED
Some College
Associate Degree
Bachelor's Degree
Master's Degree
Doctorate
Other:
How did you hear about this program?
*
Your answer
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