350 Workforce Academy Registration Form

  • 350 Workforce Academy Registration Form

    Please complete this application to apply for tuition assistance with the 350 Workforce Academy. The Workforce Training and Education Program is provided to help stabilize families by providing opportunities for participants to engage in adult education, career and technical education, and workforce training. This program is sponsored by Mississippi Department of Human Services

  • IMPORTANT ELGIBILITY REQUIREMENTS

    LOW INCOME INDIVIDUALS | PARENT OR GUARDIAN OF AT LEAST 1 CHILD (18 or younger) | RESIDES IN JACKSON METRO AREA | IF YOU DO NOT MEET THE ELIGIBILITY REQUIREMENTS YOU DO NOT QUALIFY FOR THIS PROGRAM
  • Format: (000) 000-0000.
  • Preferred Method of Communication (Select all that apply)*
  • Are you between the ages of 17-59? If yes, please provide proof of age (e.g. driver's license, birth certificate, or state ID)*

  • Emergency Contact

  • Format: (000) 000-0000.
  • Gender*
  • Are you a current SNAP or TANF recipient?*
  • Are you the parent of at least one child, 18 or younger? (Please provide a copy of the birth certificate or legal guardianship documents)*
  • What is your household size? Please enter the number of individuals in your home including yourself and dependents.*
  • What is your total income?*
  • Have you received a high school diploma or GED certificate? If yes, please provide a copy of your diploma or GED certificate.*
  • What is your highest level of education?*
  • Are you a resident of Mississippi? If yes, please provide proof of residency (e.g. current utility bill, lease agreement, etc.)*
  • Are you currently unemployed? If yes, please provide proof of unemployment (e.g. termination letter, unemployment benefits statement)*
  • Are you currently employed? If yes, please provide a copy of your last four (4) paystubs.*
  • Which Certification program are you interested in? (select all that apply)*
  • Do you have reliable transportation?*
  • Do you have access to the internet?*
  • Are you willing to participate in monthly life skills training in person at the Jackson Medical Mall?*
  • By submitting this application, do you agree that all information provided is true to the best of your knowledge?*
  • Date*
     - -

  • Please allow 2–3 business days for a follow-up. Next steps will include a follow-up email, interview scheduling, and additional details regarding the process.

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