MF Career Center Registration

Career Center Registration

Details

Background

Objectives

Work History

Supplemental

Military

Note: Veterans and "eligible spouses" receive priority of service.

Did you serve in the United States Armed Forces?*

Yes

Are you an eligible spouse of a veteran?*

Yes

Are you a spouse of a US Armed forces member on active duty and lost your job as a direct result of relocation due to a permanent change in your spouse's duty station?

Yes

Education

Are you a High School Dropout?

Yes

N/A

Note: IEP Diploma/Disabled with Certification disclosure is voluntary. You will not be penalized for nondisclosure of IEP Diploma/Disabled with certification of attendance/completion

If College, check all that apply

Some College

Vocational Degree/Certificate

Associate's Degree

Bachelor's Degree

Master's Degree

Doctoral Degree

Are you attending a secondary, post-secondary, vocational, technical or academic school full-time?*

Yes

Are you between terms, do you intend to return to school?

Yes

Driver's License

Do you have a driver's license?

Yes

Type of License:

Do you need public transportation to get to a job?

Yes

Do you have reliable transportation to and from work?

Yes

Back

3. Are you a migrant or Seasonal Farm Worker?

Yes

If yes, check one of the following:

Seasonal Farm Worker: someone who is or was employed in the past 12 months in farm work of a seasonal or other temporary nature and who can return to the permanent place of residence in the same day. This does not include non-migrant individuals who are full-time students.

Migrant Farm Worker: a seasonal farm worker (see above) who travels to the job site and cannot return to their permanent place of residence in the same day. This does not include full-time students traveling in organized groups rather than with their families.

Migrant Food Processor: (see Migrant Worker)

5. Are you a Displaced Homemaker?

Have you been providing unpaid services to family members in the home and:

Depended on the income of another family member but are no longer supported by that income, or are the dependent spouse of a member of the military on active duty and whose family income is significantly reduced due to a deployment, a call or order to active duty, or the death or disability of the member, AND
Are unemployed or underemployed and are having trouble finding or keeping employment.

Yes

6. Are you a single parent?

Are you a single, separated, divorced or widowed person who has primary responsibility for one or more dependent children under age 18 (including single pregnant women)?

Yes

7. Are you homeless?

Do you lack a permanent and suitable nighttime residence? This includes:

Sharing housing with other persons due to loss of housing, economic hardship or a similar reason
Living in a motel, hotel, trailer park or campground due to a lack of other suitable options
Living in an emergency or temporary shelter
Abandoned in a hospital
Awaiting foster care placement, or
Having a main nighttime residence that is a public or private place such as a car, park, abandoned building, bus or train station, airport or campground.

Yes

8. Are you an ex-offender?

Were you subject to any stage of the criminal justice process? Do you need help overcoming barriers to employment resulting from a record of arrest or conviction for crimes against persons or property, status offenses or other crimes.

Yes

9. Are you an English Language Learner?

Do you have limited ability in speaking, reading, writing or understanding English? Do you meet one of the following two conditions?

Is your native language a language other than English?
Do you live in a family or community where a language other than English is the main language?

Yes

10. Do you think you have a cultural barrier?

Do you have attitudes, beliefs, customs or practices that may make it hard for you to find work?

Yes

11. Do you lack basic skills?

Are you unable to solve problems, or read, write, or speak English at a level necessary to function on the job, in your family, or in society?

Yes

I hereby certify that all of the information provided by me on this form is correct, accurate and complete to the best of my knowledge.

Type Your Name below:

How did you hear about HempsteadWorks?

The Workforce Innovation and Opportunity Act financially assisted program is an equal opportunity employer / program. Auxiliary aids and services are available upon request to individuals with disabilities. To request reasonable accommodation, please call Maria Lombardi at (516) 485-5000 ext. 1113.

An error occurred. Please make sure you have filled out all the required fields. Please type "n/a" in a required box if it does not apply to you.

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Certificate/Licenses

Do you have an occupational certificate or license?*

Yes

Add another Certificate/License

Schools

Do you have a college degree, diploma, or educational certificate?*

Yes