OhioMeansJobs Warren County WIOA Adult Funding Interest Form

OhioMeansJobs Warren County WIOA Adult Funding Interest Form

WIOA training is specifically designed for eligible individuals who are looking to further their education or upgrade their skills. Through tuition-paid training supported by OhioMeansJobs Warren County, students can acquire the necessary skills to enhance their employability and succeed in today’s highly competitive job market. Please note that filling out this interest form DOES NOT count as applying for funding. To apply for funding, you must first attend an in-person orientation session. Additionally, applying for funding does not guarantee that you will receive financial assistance. Please complete the following questions to register for our next orientation session.
Full Name*

First NameLast Name
Contact Number*
Please enter a valid phone number.
Email Address*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County of Residence*
How did you hear about us?*

FacebookInstagramLinkedInWeb SearchSchool ReferralWord of MouthUnemploymentOther
Date of Birth*

MonthDayYear
Date
Marital Status*

SingleMarriedSeparated
Family Size*

12345678 or more
High school graduate or GED obtained?*

YesNo
Name of School & Graduation Year:*
List all vocational school certifications, apprenticeships/journeyman ratings, professional certifications, state licenses, professional licenses, and degrees that you have earned. Please include the year and the organization from which you received. Respond N/A if there are none. *
Have you or anyone in your household received the following in the past six months?*

Cash AssistanceSNAPNo
Are you currently employed?*

Yes, full timeYes, part timeNo
Name of current employer, if applicable:
Hours worked per week:
Pay rate:
What is your family gross income for the past 12 months?*
If unemployed, what is your current unemployment status:*

I have not filed unemploymentClaim filedReceiving benefitsExhausted benefitsN/A
Are you a military veteran or spouse of a veteran?

YesNoPrefer not to answer
List any criminal convictions & years. Respond N/A if there are none:*
List any driving convictions & years. Respond N/A if there are none:*
What training program are you interested in?*
What school are you considering?*
Comments:
I acknowledge that this form is for expressing interest and does not guarantee funding. I confirm that the information provided is accurate to the best of my knowledge.*

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