Registration for JobFit
Name
*
First Name
Last Name
Preferred Pronouns
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Age
Learning Disability Type(s)
Education Background. Check all that apply.
High School (in progress)
High School (completed)
College
University
Other
Current Employment Status. Check all that apply.
Working, part-time.
Working, full-time.
Not working, unemployed with past work experience.
Not working, unemployed with no work experience.
Your availability. Facilitators will choose a time to meet that fits with the most participants' schedules. Zoom sessions will take place in the evening.
Do you consent to Zoom sessions being recorded for participants who are unable to make it?
Yes
No
Maybe
Do you have access to a personal device (e.g., smart phone, tablet, computer, etc.) to attend sessions?
Yes
No
Maybe
Do you have any access needs that we should be aware of (e.g., closed-captioning, high contrast, break/rest periods, etc.)?
Back
Next
What are you most interested in learning through this program?
Is there anything you would like to learn that is not already being covered? (see program description/flyer for topics to be covered)
What are some barriers you've experienced trying to find employment?
What are some challenges you’ve experienced during employment?
Is there anything else you would like to share with the facilitators ahead of our first session?
Submit
Should be Empty: