Career Center Seminar (CCS)

Name *

First

Last

Jobseeker ID# *

Phone# *

Enter phone number - no dashes

Email *

Are you a Veteran? *

YES
NO

public a as

Are you currently receiving, or in the past 6 months received, either individually or member of a household, public assistance such as TAFDC, SNAP or Chapter 115? *

YES
NO

Are you experiencing homelessness? *

YES
NO

Do you think that you might test below 8th grade in reading? *

YES
NO

Do you think that your household might meet Low Income level? *

YES
NO

Are you unemployed? *

YES
NO

Are you receiving or exhausted Unemployment benefits? *

YES
NO

Did you receive a letter of layoff from your employer? *

YES
NO

Have you been financially supported by another individual who is no longer supporting you through no fault of your own? *

YES
NO

Are you the spouse of a Veteran relocating? *

YES
NO

Are you authorized to work in the US? *

YES
NO

What city/town do you currently live in? *

What city/town of your last employer? *

Are you interested in (choose one): *

One on one job search assistance only
Applying for training funds and one on one job search assistance

MassHire Metro North Training Information Form