Job Seeker Input Form
Please complete this short form. We use this information to get in touch with you and to assign a mentor to you, if requested.
All information is confidential.
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Job/Career Interest Areas
Please tell us a little more about your situation
How long have you been looking for a job?
Highest Level of Education
Trade, community college, or other associate degree (2 year)
Undergraduate college (4 year)
Graduate education (Master's or PhD)
Prefer not to say
How did you find out about us?
I am a past participant
Referred by a current or past participant
Referred by a family member, friend, mentor, or colleague
Referred by a recruiter or staffing agency
Referred by WorkSource, career coach, job support, or other networking group
Learned about Job Seekers from my church, school, or professional organization
Website search, social media, or other online source
Have you been a part of our program and been assigned a mentor in the past?
If "Yes," who was your mentor?
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