Name
*
First Name
Last Name
Phone Number (primary contact)
*
Please enter a valid phone number.
Email
*
example@example.com
Zip Code
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your age range?
*
Under 25
25–39
40–54
55 and over
Can you commit to a 20-week training program starting February 23?
*
Yes
No
Not sure
Are you able to attend in-person labs every other Thursday, 8:00 AM–12:00 PM?
*
Yes
No
Not sure
Do you give permission for a Goodwill Dallas case worker to contact you about next steps?
*
Yes
Preferred Method of Contact
*
Call
Text
Email
Are you able to attend in-person labs every other Thursday, 8 am – 12 pm at 3020 Westmoreland Drive?
*
Yes
No
Not sure
Submit
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