Job Seeker Connect

First Name

Middle Name

Last Name

Street

City

State/Province

Zip

Country

Phone

Mobile

Email

Date of Birth

Gender -None-FemaleMale

Number of Dependents

U.S. Citizen -None-NoYes

Veteran -None-NoYes

Are you currently employed? -None-NoYes

Reason for Unemployment I just completed high school, college, or some other form of education/trainingLay offTerminationQuitI am actively seeking employment but cannot get an interviewOther

"Other" reason for unemployment:

How long have you been unemployed? -None-Less than 6 months6 months or moreI am currently employed

Highest education level -None-8th Grade or Less9th-12th, no diplomaHigh School diploma or GEDSome CollegeAA DegreeBA Degree or Higher

Do you have any certifications? CDL (Commercial Driver’s License)Heavy Equipment (Ex: Forklift, Manlift, Crane)TWIC (Transportation Worker Identification Credential)OSHA (Occupational Safety and Health Administration)FirewatchNCCER (National Center for Construction Education and Research)A&P (Airframe and Powerplant)CNA (Certified Nursing Assistant)AvionicsOther

"Other" certifications:

Previous work experience in industries HealthcareAviationMaritime (Shipbuilding and Repair)ManufacturingConstructionOther

"Other" work experience industries:

Industries that interest you HealthcareAviationMaritime (Shipbuilding and Repair)ManufacturingConstructionAll of the aboveI don't know what industries I am interested inOther

"Other" industries interested in:

Most recent hourly wage -None-I have never been employedLess than $7.25$7.25 – $9.99$10.00 – $12.49$12.50 – $14.99$15.00 – $17.49$17.50 – $19.99$20.00 or more

What language(s) do you speak? EnglishSpanishOther

"Other" language spoken:

Race -None-African AmericanAsianWhiteHispanicMultipleOther

"Other" Race:

Ever been convicted of a felony? -None-NoYes