Please answer the following questions to the best of your ability. All answers are confidential.

Once you submit your application, one of our career counselors will review it and contact you to inform you of your eligibility for the program. Additionally, individuals can schedule appointments to visit their local job centers in Joplin or Monett, where they can speak with a counselor in person about available programs, services, and opportunities.
To be eligible for the program you must:
1) Be 16-24
2) Registered for the Selective Service (if applicable)
3) Be eligible to work in US
AND BE COMMITTED TO MAKING A POSITIVE CHANGE IN YOUR LIFE.

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* 1. Please provide the following information:

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* 2. Please indicate your level of education.

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* 3. SELECTIVE SERVICE

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* 4. Marriage Status

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* 5. Please check any of the services you are interested in from the list below (check all that apply).

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* 6. Please describe your current situation (check all that apply).

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* 7. Were you referred to the program by another organization or individual?

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* 8. How did you hear about our programs (Facebook, Job Center, Friend, Family, etc.) This is VERY important - PLEASE respond.

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* 9. Please indicate your gender.

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* 10. Of which racial or ethnic group do you consider yourself a member?

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* 11. Is English your first language?

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* 12. Do you have a disability?

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* 13. Are you currently working with Voc-Rehab?

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* 14. Do you have a Felony Conviction?

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* 15. Migrant Worker- Only check the answers that may apply to you.

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* 16. Do you have a MoJobs job seeker account?  (if not, you can create one at jobs.mo.gov)

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