Groundwork Rhode Island Environmental Job Training Program Online Application
All information will be kept confidential. If you would like a paper application or have any questions, please contact (401) 305-7174 or
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Name *
Date of Birth *
Age *
Gender *
Permanent Address *
Number, Street, Apt. Number, City, State, Zip Code
Home Phone
Cell Phone
Best time to reach you by phone?
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Do you prefer being called on your home phone or cell phone?
Do you prefer text messages?
Email *
Are you a public housing resident?
In case of an emergency, who should we contact? *
Full Name, Phone Number (Home and Cell), Address
Relationship to you? *
What languages do you speak? *
How did you find out about Groundwork RI's job training program? *
Have you previously applied for this program? *
Do you know anyone who has previously participated in our program? *
Why are you interested in participating in this job training program? *
Please tell us how you describe yourself in terms of your race and/or ethnicity.  You can choose more than one option.
Are you a veteran of military service?
If yes, which branch?
Do you have a conviction record? *
If yes, you should plan to provide details in the interview.  Individuals with conviction records are encouraged to apply.
Have you ever been convicted of a felony? *
Are you currently on probation or parole? *
If yes, until when?
Name and Phone Number of Parole Officer
Do you have any health problems or disabilities that may prevent you from fully participating in the training, or that would limit the types of work you are best suited for (can’t lift over certain weight, severe asthma, etc.)? *
Do you have any allergies (food, medicine, certain materials, grass/pollen, etc)? *
What is the school you most recently attended and when? *
Did you graduate from high school? *
What is the highest grade you have completed? *
If you did not graduate, have you completed a GED or equivalent?
Have you attended other training programs in the past?
If yes, please describe.
What is the average yearly income for your household? *
Does your household currently receive assistance from the State of RI? *
Do you currently have a resume? *
Are you currently employed? *
Out of the last twelve months, how many months did you work? *
Do you have any volunteer or community service experience? *
If yes, please describe.  
Which of the following technologies do you have confidence using? *
Please list your 3 most recent jobs. *
Include Employer Name, Address, Hours Worked per week, What Position and Duties you had, When you worked there, and Hourly Wage
What were your reasons for leaving your 3 most recent jobs? *
Do you have any experience in construction, renovation, labor, etc.? *
How many years of experience? *
Do you have any other skills or certifications/licenses (CDL, others) that will aid you in your job search that we should know about? *
Are you available Monday thru Friday from 8:30 am – 4:30 pm? *
Do you have a valid driver’s license? *
If no, what is your reason for not having a driver's license?
How will you get to class? *
Do you have any history of substance and/or drug abuse that program staff should be aware of? *
If yes, you should plan to provide details in the interview.
Do you have sufficient child care coverage during class time(s)? *
What hobbies, sports, or other community activities do you enjoy and actively participate in? *
I certify that all information on this application is complete, accurate, and true to the best of my knowledge. I realize that any false statements that I know that I have made may cause this application to be rejected, or if I am enrolled in this program, may result in my termination in the program. I also understand that I am not guaranteed employment through completion of the Groundwork Rhode Island Adult Environmental Job Training Program. *
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