Scholarship Request Form

Scholarship Request Form

Complete this application so WIOA can offer the most appropriate services for your needs.
After submitting this form, you will receive an email with your responses. Expect a follow-up phone call within 2 business days.
Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Are you a veteran?

YesNo
Are you employed?

YesNo
City of residence?
What is your age?*

16-2425+Prefer not to say
Have you received Supplemental Nutrition Assistance Program (SNAP) benefits any time in the past 6 months?*

YesNoI don't know
Do you receive or have exhausted unemployment insurance benefits?*

YesNoI don't know
Do you have a high school diploma or GED?*

YesNoPrefer not to say
What training program are you interested in?*
What school do you plan to attend?*
When do you plan to attend?*
How did you find out about the scholarship?*
Would you like to be added to the Kankakee Workforce Services email list to be notified of important events and information?

YesNo
Should be Empty: