Youth Workforce Center OSY Interest Form
*********************************************** IMPORTANT ***********************************************

Greetings prospective students! Thank you for your interest in the Youth Workforce Center's Out-of-School Youth Program. Please complete the following INTEREST FORM as HONESTLY as possible. Once you have completed the interest form we will reach out to you to inform you of the next steps.

NOTE: THIS IS NOT AN APPLICATION FORM. PLEASE CAREFULLY FOLLOW ALL INSTRUCTIONS TO COMPLETE THIS INTEREST FORM.

The Youth Workforce Center is an equal opportunity employer/program and auxiliary aids and services are available upon request to individuals with disabilities. VA Relay: 711. The Youth Workforce Center is funded 100% ($764,750) through WIOA Title I funds via an award made to New Horizons Regional Education Centers via Hampton Roads Workforce Council via pass through entity Virginia Department of Workforce Development and Advancement.  
Email *
Untitled Title
Untitled Title
First and Last Name *
Date of Birth ( Month, Day, Year) *
MM
/
DD
/
YYYY
Phone Number (including area code) *
Full Current Address (including city and zip code) *
Occupational Skills Training Interest  *
What is your current age? *
Are you a United States Citizen or do you have the right to work in the United States? *
Required
Have you registered for selective service? This applies to males only. *
Required
Do you have a high school diploma or GED? *
Required
Are you a school drop-out? *
Do you have children? *
Are you currently homeless? *
Are you currently in foster care or have you aged out of foster care? *
Do you have a documented disability? Please answer honestly, your response will not automatically disqualify you from the program. *
Do you receive any of the following benefits? *
Required
Have you ever worked before?   *
Required
Have you worked in the past six (6) months?   *
Required
if you have worked in the last six (6) months, were you a part time or full time employee? *
Required
If you have worked in the past six (6) months how much did you earn per hour? Put 0 if you did not work. *
Do you have a United States driver's license? *
Have you been arrested or charged with an offense other than a minor traffic infraction? Please answer honestly, your response will not automatically disqualify you from the program.  *
Are the child of a currently incarcerated parent or legal guardian?  Please answer honestly, your response will not automatically disqualify you from the program.  *
How did you hear about us? *
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