Successful Interviewing Strategies 3.22.2018
If you require accommodations to participate in this class, please contact Melinda Wildes at 593-7942 or melinda.wildes@maine.edu

​Thank you for providing the following information. Your name and contact information will not be shared. Aggregate data is used for the pu​rposes of reporting to our funders and measuring the success of our programs.

​All fields are required on the registration form. Please contact ​Melinda at 593-7942 or melinda.wildes@maine.edu if you prefer a paper copy or have any questions​. If you have taken a class with NVME recently, contact Melinda. Your registration information may already be on file.​

​​You may be contacted in the future to provide feedback on your experience with NVME.​

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? *
Required
Gender
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.
If you consider yourself Hispanic or Latino, please check here.
In addition, check one or more of the following racial categories to describe yourself. *
Required
If you chose other above, please list here.
Your answer
Work Status *
Required
I have a disability that limits my work *
Required
I receive SSI, SSDI, or veterans disability? *
Required
I am a veteran, active duty military or reservist *
Required
I receive unemployment insurance (UI)? *
Required
I am looking for work *
Required
Education Information *
Required
Are you currently enrolled in school? *
Required
If you are currently a student, what kind of program are you enrolled in?
Major field of study?
Your answer
Are you a University of Maine Augusta student? *
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) *
Are you the Head of Household? *
Are you a single parent? *
My household receives food stamps. *
My household receives TANF. *
I have savings. *
I have retirement savings. *
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