Invitation to Apply for Pre-Employment Training

First Name*

Last Name*

Phone Number*

If you do not have a phone, please enter 555-555-5555 and be sure to provide an email address so that we can reach you.

Email*

If you do not have an email address, please enter noemail@pmcrenewal.com and be sure to provide a phone number so that we can reach you.

Which program are you applying for?*

You MUST live in one of the communities above to qualify.

Your Address

Street Address Address Line 2 City Province / Territory Postal Code

Gender

Date of Birth

Have you faced difficulties in finding employment?*

Yes
No

What barriers to employment do you face? (please describe any disability that you may have, diagnosed or undiagnosed)

Please describe why you think you are a good candidate to participate in this pre-employment training program?

Do you have a bank account?

Yes
No

Do you have two pieces of photo ID?

Yes
No

Are you available for interviews the week of September 11th?

Yes
No

Are you available to participate every week day during the program (you will be paid a participation incentive and a completion bonus for participation).

Yes
No

Referral

Did someone refer you to this program?*

Name of person who referred you:*

Email or Phone Number of person who referred you:*

Why are we asking this?

We are asking for the contact information of the person who referred you because if you are accepted into the program they will be entered into a draw. We will only use this information to contact them if they win.

Invitation to Apply for Pre-Employment Training

Pre-Employment Training Application (Invitation Only)

Referral

Why are we asking this?