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CAP Application
The Chatham Apprentice Program (CAP) is a cornerstone workforce development program targeting those who are unemployed and underemployed in Chatham, Effingham, Liberty, and Bryan counties with services and training aimed at helping them become stabilized in employment. The program includes hard and soft skills training coupled with wrap-around services. Apply today using the form below.
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Option 1
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Please choose a preferred location for in person learning:
*
Online Session (9:00 a.m.- 12:00 p.m.) LIMITED SEATS AVAILABLE
Moses Jackson Advancement Center (9:00 a.m.- 12:00 p.m.)
Pennsylvania Avenue Resource Center (9:00 a.m. - 12:00 p.m.)
Which class are you interested in:
*
January 8 - February 1, 2024
February 19 - March 11, 2024
April 8 - May 2, 2024
May 20 - June 13, 2024
First Name:
*
Your answer
Middle Name:
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Your answer
Last Name
*
Your answer
Birth Date
*
MM
/
DD
/
YYYY
Home Address
*
Your answer
Mailing Address (if different from home)
Your answer
Apartment/ Unit #
Your answer
City:
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Your answer
State:
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Your answer
Zip Code:
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Your answer
Email:
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Your answer
Phone Number:
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Your answer
What is your race?
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African American
Caucasian
Hispanic or Latino
Asian
Pacific Islander
American Indian/Alaska Native
Multi-Racial
Other (please specify): _____
What is your current gender identity?
*
Female
Male
If you prefer another term, please specify: _________________
Decline to answer
Are you a citizen of the United States?
Yes
No
Clear selection
If no, are you authorized to work in the United States?
Yes
No
Clear selection
Are you a veteran?
*
Yes
No
How did you hear about the Chatham Apprentice Program (CAP)?
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Family/ Friend
Flyer/ Banner
Facebook
Step Up Savannah/ Chatham Apprentice Program
Other:
Applicant's marital status:
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Single
Married
Legally Separated
Divorced
Widowed
What is the primary language spoken in your household?
*
Your answer
Emergency Contact: Please list a relative or friend who would definitely know how to contact you, even if you move. (Name and Phone) :
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Your answer
Do you have a High School Diploma/GED?
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Yes
No
What is the highest degree or level or level of school you completed? If currently enrolled, the highest degree received.
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No formal education
Nursery school to 8th grade
Some high school, no diploma
High school graduate, diploma or the equivalent (for example: GED)
Some college credit, no degree
Trade/ technical/ vocational training
Associate degree
Bachelor's degree
Master's degree
Professional degree
Other:
Required
Please list any credentials you have:
*
Your answer
Do you / your family have any special needs staff should know about?
*
Your answer
Do you or someone in your household receive any of the following? (Please check all that apply)
*
TANF
Medicaid
SNAP/EBT
SSI/Social Security
SSDI
Required
Please check the amount closest to your yearly income:
*
$0-$9,999
$10,000-$14,999
$15,000-$24,999
$25,000-$34,999
$35,000-$49,000
$50,000-$74,999
$75,000 and above
No Income
Required
Are you currently employed?
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Yes
No
How many months have you worked in the past year?
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Your answer
Name of Company
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Your answer
Status:
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Full-Time
Part-Time
Temporary
Contract
Other:
Required
What is the start date of the current job?
MM
/
DD
/
YYYY
What is the end date of the current job?
MM
/
DD
/
YYYY
Rate of Pay: (Current Job)
Your answer
Reason for leaving the current place of employment.
Your answer
Name of Company
Your answer
Status:
*
Full-Time
Part-Time
Temproary
Contract
Unemployed
Other:
Required
What is the start date of the previous job?
*
MM
/
DD
/
YYYY
What is the end date of the previous job?
*
MM
/
DD
/
YYYY
Rate of Pay: ( Previous Job)
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Your answer
Reason for leaving the previous job:
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Your answer
What job skills do you have? ( Please check all that apply)
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Agricultural laborer
Artist, Entertainer, Sportsperson, or Media
Automotive Work (e.g., gas station attendant, auto repair)
Administrative, Secretarial
Business and Financial Support (e.g., Bookkeeper, Accountant, Auditor, Bank Teller)
Community and Social Service Worker (e.g., Case Manager, Counselor, Social Worker)
Construction Worker
Day Care Provider/Babysitter Driver (truck, school bus, commercial, etc)
Education/Trainer (e.g., Teacher, Teacher Assistant, Instructor)
Environmental Remediation (Lead Abatement)
Food Server (e.g., Waiter, Waitress, Hostess, Cashier)
Food Service Preparer (e.g., Fast Food, Chef, Dishwasher)
Health Care (e.g., Home Health Aide, Nursing Aide)
Home, Building, and Grounds Cleaning and Maintenance (e.g., Housekeeping, Cleaning, Custodian, Landscaper)
Installation, Maintenance, and Repair Worker
Law Enforcement/Security Officer (e.g., Police or Fire Officer, Security Guard)
Warehouse and Forklift
Other: _____________________
Required
What Credential Are You Interested In?
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Emergency Medical Technician (EMT)
EMTR
Fire Fighter
Forklift Safety
OSHA-10
ServSafe Food Handler
TWIC
Registered Behavior Technician (RBT)
ServSafe Manager
Dispatch Trainee
Partial CDL Scholarship
Jockey Truck Operator
Please write at least THREE COMPLETE SENTENCES explaining your goals for this program
*
Your answer
Which of the following reasons have prevented you from steady employment? Please check all that apply
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Lack of reliable transportation
Own health, disability
Lacks necessary schooling/training/skills/experience
Pregnancy or just had a baby
Prior incarceration/probation/criminal record problems
Relocation/Residency issues
In drug rehabilitation/treatment program
Lack of education and training
Looking for housing
Working with a temp agency/ no steady work
No High School Diploma or GED
Other:
Required
Have you ever been convicted of a felony?
*
Yes
No
Do you currently have pending charges?
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Yes
No
Are you a registered sex offender?
*
Yes
No
Are you currently on probation or parole?
*
Yes
No
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