What is your first, middle initial and last name? *
Your answer
What is your date of birth? *
MM
/
DD
/
YYYY
What is your sexual orientation? (Your information is kept private and confidential *
What is your contact number? *
Your answer
What is the name and phone number of your emergency contact? *
Your answer
Do you have two forms of identification? *
What two forms of identification do you have? *
Required
Where do you currently live? Your full address is required. *
Your answer
Do you have a high school diploma or GED? *
If you answered "No" to the previous question, would you like to receive your high school diploma or GED? *
What is the highest level of education you have achieved? *
The JET program requires participants to actively engage in the program activities up to completion. What barriers do you have that may keep you from completing the program? *
Your answer
Have you ever been arrested for criminal or delinquent activity? *
If you answered "YES" to the previous question, please explain:
Your answer
Why are you interested in the JET program? *
Your answer
Describe your "Dream Job". *
Your answer
Do you have access to or own a laptop, tablet, or chrome book? *
Why would you like to be a part of the JET (Jobs and Entrepreneurial Training) program? *
Your answer
Additional information you would like for the JET staff to know about you: *