ReSET Job Training Program Online Application
This is the online application form for the ReSET (Skills Employment Training) Job Training Programs, offered by Finger Lakes ReUse, Inc. (www.fingerlakesreuse.org). Please fill out all required fields. If you have questions about ReSET, or this application, please contact our Community Programs Coordinator at anise@fingerlakesreuse.org or (607) 257-9699.
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Current Address (Including, City and Zip Code) *
Telephone number *
Please include area code. Please be sure voice mail is set up on cell phones, otherwise chances to interview may be missed.
Email Address *
Which is the most reliable way to get a hold of you? *
Birth Year *
We accept applicants 16+. We do not descriminate based on age. The question is for demographic purposes.
What are your preferred gender pronouns? *
ex. She/her/hers, They/them/theirs, He/him/his. We ask only so that we have a sense of how you would like us to refer to you.
Because we receive Federal funds for this program, the following information must be collected and is intended solely for record keeping, and to help identify additional resources that can assist you in your return to work. Your answers will be kept confidential.
Ethnicity *
Note: This next section is voluntary. This information will be kept confidential and is intended solely to help identify additional resources that can assist you during this training. You will not be penalized for refusal to answer.
Are you a person with a disability or physical limitation?
Clear selection
Do you require any accommodations for your disability or physical limitation?
Please describe below.
Household Information
The following information is to gauge your general income levels as this program is geared to individuals with low to moderate income.
How many people live in your household? *
During the past 6 months, what was your household's gross income (before taxes/deductions)? *
$______ (This number can be a rough estimate if you do not know your exact gross income.)
How or where did you hear about ReSET? *
If the applicant is filling out this application with human services provider, please include name, organization name and contact info of the service provider.
Do you have experience with incarceration (jail or prison)? *
This question is only asked for records purposes. No one will be treated differently or denied access to ReUse programs because of criminal history.
Which training program are you most interested in? *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Fingerlakesreuse.org.