Project Request Form

2. First Name*
3. Last Name*
5. Email Address
6. Phone Number
8. City*
9. Zip Code*
11. Are you currently employed?
    -- Select One --Yes full-timeYes part-timeUnemployedStudentSeeking a career change
12. If employed, are you looking for:*
    -- Select One --Better payCareer advancementDifferent industryRelocationOther
14. What industries are you most interested in?*
    -- Select One --HealthcareRetailLogisticsManufacturingPublic SectorSkilled TradesProfessional Services
15. Years of work experience*
    -- Select One --0-12-56-1010+
17. Highest level of education completed*
    -- Select One --Less than High SchoolHigh School Diploma or GEDSome College (No Degree)Associate DegreeBachelor’s DegreeMaster’s DegreeDoctorate (PhD, EdD, etc.)Trade School / Technical CertificationCurrently Enrolled in High SchoolCurrently Enrolled in College or Trade Program
18. Do you hold any certifications or licenses?*
    -- Select One --CDLHVACCNAOther
20. Are you interested in:*
    -- Select One --Full-timePart-timeContractInternshipApprenticeshipOther
21. What are you interested in?*

    1. Full-time
    2. Part-time
    3. Contract
    4. Internship
    5. Apprenticeship

    Check all that apply. 

23. Would you be interested in workforce training programs offered locally?*
    -- Select One --YesNo
24. How did you hear about this job fair?*
    -- Select One --Social mediaCity websiteSchoolEmployerFriendOther
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit Submit and Print

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