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
Age Requirement
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
Should be Empty:

Employment & Training Program Pre-Screening Form