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W.O.R.K. Application
Workforce Orientation and Retraining Keys Application - Arkansas Northeastern College - The Solutions Group
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Full Name
*
Your answer
Birthdate
MM
/
DD
/
YYYY
Address
Your answer
City
Your answer
State
Choose
Arkansas
Missouri
Zip Code
Your answer
County
Your answer
Phone Number
Please enter a good working phone number for us to contact you when a class becomes available.
Your answer
Sign up for text messaging?
For information about surveys and upcoming classes or even the status of a class.
Yes
No
Clear selection
Email Address
Please put your email address, as this will be critical information for when we collect surveys about your employment.
Your answer
Please Choose the following
*
I am currently employed
I am receiving unemployment
I am receiving other government assistance
Unemployed but not receiving benefits
Other:
If you answered employed what is your hourly rate?
Your answer
Please choose the following
*
U.S. Citizen
Non-Resident Alien
Resident Alien
Have you ever been convicted of a felony?
*
Yes
No
If you answered yes, What year were you convicted?
Your answer
In case of emergency:
Include: Contact Name & Phone Number
Your answer
Skills/Certifications
Please list any skills you have and certifications. This will be helpful when we try to place you in a job. Example: CDL Truck driving license, Construction Background, or Welding Skills.
Your answer
Are you a veteran?
*
Yes
No
Are you a dislocated worker?
*
Yes
No
If you answered yes to the dislocated worker question - please list the company where you previously worked.
Your answer
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