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* 1. Would you like assistance with job search or employment placement?

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* 2. Are you interested in enrolling in career training classes?

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* 3. Are you over 65 and need assistance with daily living activities such as meals, laundry and housekeeping?

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* 4. Do you have anyone in your household between the ages of 16 and 24 who dropped out of high school at any time?

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* 5. If you are under the age of 64 and receiving SSI or SSDI benefits, are  you interested in going to work?

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