HOPE E&T Pre-Screening Form

Employment & Training Program Pre-Screening Form
Applicant Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Eligibility Questions
I am between the ages of 18 and 59I am under 18 or over 59
1. Are you currently unemployed and looking for work or under-employed?*
2. Are you declared disabled and receiving Social Security benefits that prevent you from earning additional income?*
3. Do you have regular access to the internet?*
4. Do you have access to a computer, laptop or tablet?*
Unfortunately, you do not meet the eligibility criteria for this program. If you have questions, please contact (773) 921-2243
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Employment & Training Program Pre-Screening Form