WIOA Am I Eligible

Am I Eligible

WIOA

NOTE: TO HELP DETERMINE IF YOU MAY BE ELIGIBLE FOR WIOA SERVICES THROUGH WORKSOURCE FULTON, PLEASE COMPLETE THE FORM BELOW WITH INTERNET EXPLORER (IE) ON A WINDOWS MACHINE.

Title

First Name

Last Name

Street Address

City

State

Zip Code:

Email Address: Phone Number:

How many people are in your household? Be sure to include yourself and each family member currently living in the home that is related by blood, marriage, foster care, or adoption.People in household Does your household live in Fulton County Georgia? No Yes

How many people in your household between age 16-21? Are any member(s) of your household, between age 16-24 (check all that apply)? In school Basic skills deficient An offender Pregnant or Parenting Homeless or a runaway A foster care, kinship guardianship, or adopted youth An individual with a disability Require additional assistance to complete an educational program Need assistance to secure employment NONE

How many people in your household are disabled? How many people in your household are veterans? How many people in your household are receiving or have received/exhausted unemployment in the last 6 month?

If answered one or more people, was the employer/company located in Fulton County? No Yes

How many people in your household are employed? How much income has your household earned in the last 6 months (before taxes)?

Center Locations for training:South Fulton Career Center - 5710 Stonewall Tell Rd, Suite 160 - College Park, GA 30349North Fulton Career Center - 7741 Roswell Rd, Suite 205 - Sandy Springs, GA 30350Select the Center Location Nearest You:Nearest Center location for training South Fulton Career Center North Fulton Career Center

Fulton County WorkSource Georgia is an equal opportunity employer/program.Citizens in need of reasonable accommodations due to a disability including communications in an alternative format should contact the Disability Liaison Karen Sessoms, Human Resources Manager, Department of Community Development, 137 Peachtree Street, SW, Atlanta, GA 30303, within five days of an event at (404) 612 9802. For Georgia Relay Access, dial 711

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