Register for Interview Strategies on Thursday 3/24/22, 10

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If you require accommodations to participate in this class, please contact Tom Grogan at thomas.grogan@maine.edu or 207-262-7843.

Thank you for providing the following information. Your name and contact information will not be shared. Aggregate data is used for the purposes of reporting to our funders and measuring the success of our programs.

All fields are required on the registration form. Please contact Tom at 207-262-7843 or thomas.grogan@maine.edu if you prefer a paper copy or have any questions. If you have taken a class with NVME recently, contact Tom. Your registration information may already be on file.

You may be contacted in the future to provide feedback on your experience with NVME.

Name - First *

Name - Middle

Name - Last *

Date of Birth *

Street Address *

City *

State *

Zip *

Email *

Phone number *

Alternate phone number

How did you hear about us? *

Sign me up for the email news about NVME programs. *

Yes

Required

Gender

Female

Male

Gender-expansive

If you would like the opportunity, we invite you to say more about your gender identity here:

I am of Franco-American heritage *

Yes

Unsure

I am Hispanic or Latinx. *

Yes

Unsure

Check one the following to describe yourself. *

White

Asian

Native Hawaiian or Pacific Islander

Black or African American

Native American or Alaska Native

Required

If more than one of the above applies to you, describe here. *

Work Status *

Employed

Employed part-time or seasonal

Unemployed

Self-Employed

Retired/semi-retired

Required

I have a disability that limits my work *

Yes

Required

I receive SSI, SSDI, or veterans disability? *

Yes

Required

I am a veteran, active duty military or reservist *

Yes

Required

I receive unemployment insurance (UI)? *

Yes

Required

I am looking for work *

Yes

Required

Education Information *

Did not complete high school

High school dimploma/HiSET/GED

College coursework

Trade School certificate

Associates Degree

Bachelors Degree

Post-bacculete coursework

Graduate degree

Other

Required

Are you currently enrolled in school? *

Yes

Required

If you are currently a student, what kind of program are you enrolled in?

HS/HiSET/GED

College prep

Trade School

Associates Degree

Bachelor Degree

Graduate Degree

Major field of study?

Are you a University of Maine Augusta student? *

Yes

Number of people in your household including you *

Total annual income for your household (from all sources) *

Health Insurance coverage (choose one) *

Self- if household of one insurance, select this

Some members

All household members

No one

Are you the Head of Household? *

Yes

Are you a single parent? *

Yes

My household receives food stamps. *

Yes

My household receives TANF. *

Yes

I have savings. *

Yes

I have retirement savings. *

Yes

Submit

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