Program Questionnaire

Eligibility

• Minimum age 18

• Minimum High School Diploma or GED

• Must be fluent in English

• Valid California ID

• Must be eligible to work in the United States

• Achieve required grade levels in math and reading assessments

• Acceptance conditioned upon passing criminal background check

• Must commit to perfect attendance for the duration of the training program

• Drug screening (includes marijuana)

• COVID vaccine may be required as a condition to secure employment after completing the training program, unless exemption is granted by the employer.

First Name*

Last Name*

Email*

Phone*

Date of Birth*

Address*

City*

State*

ZIP Code*

Which program are you interested in applying for?*
Please select oneApartmentWorksBankWork$CareerWork$ MedicalHealthWorks

Have you applied to any JVSWorks programs previously?*
Please Choose OneYesNo

If YES, what program(s) have you applied to?

ApartmentWorksBankWork$CareerWork$ MedicalHealthWorks

Are you 18 years of age or older?*
Please Choose OneYesNo

Do you currently have a valid California Driver’s License or California ID?*
Please Choose OneYesNoDo not currenlty have one but can apply for one

Do you have a high school diploma or GED?*
Please Choose OneYesNo

Can you provide proof of your legal right to live and work in the United States?*
Please Choose OneYesNo

Are you a U.S. military Veteran?*
Please Choose OneYesNo

Military Branch?
Please Choose OneAir ForceArmyCoast GuardMarinesMerchant MarinesNational GuardNavyUnknown

How did you learn about the program?*
Please select oneAlumniInternet SearchCommunity OrganizationCraigslistFacebookInstagramLinkedInWorkSource Center/America's Job Center of California/One-StopOther

Tell us more about the person or place that told you about the program.
(required if Alumni, Community Organization, WorkSource Center/America's Job Center of California/One-Stop or Other selected above):

Employment History

Current or Last Employer*

Company Name*

Company Job Title*

Company Start Date*

Company End Date

+ Add Another Employment

Resume

Are you fully vaccinated against COVID-19?*
Please Choose OneYesNo

If not, are you planning on getting vaccinated?
Please Choose OneYesNo