Enroll

Name

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Email

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Guardian Name

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Guardian Email

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Guardian Phone

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Are you eligible for work in the United States?

YesNo

How prepared do you feel about applying for jobs?

1 is not prepared, 10 is mostly prepared

If all jobs paid the same, what would you like to do for work?

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What is your biggest challenge in getting and keeping a job?

0 / 5000

How many hours per week are you interested in working?

5 – 10 hours10 – 20 hours20 – 30 hoursFull Time

Pick Class Sessions, all sessions meet from 5pm – 8pm at Lois Curtis Center 1921 SE Indiana Topeka, KS 66607

Get a Job Fall Session 1 (M & W) – September 7 & 9, September 14 & 16 , September 21 & 23Get a Job Fall Session 2 (Tu& Th) – September 8 & 10, September 15 & 16, September 22 & 23Get a Job Fall Session 3 (M & W) – November 2 & 4, November 9 & 11, November 16 & 18Get a Job Fall Session 4 (Tu & Th) – November 3 & 5, November 10 & 12, November 17 & 19

Do you have employers you’d really like to work for but don’t have them in your network of contacts?

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Are you able to meet for every session in your choice of dates?

YesNo

What might keep you from participating in every session?

0 / 5000

Would you be available for 20 hours of Community Service to get a valid reference?

YesIt might be challengingNo

Thank you!

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