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EnVision Center | Career Readiness Assessment
Please complete the following form. Fill in the blank where necessary. Check all that apply under each category.
For more information or questions, please contact Jared Nava-Salgado at 828.485.4234 or via email at
jared@wpcog.org
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* Indicates required question
Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Mailing Address
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Additional Contact Phone Number
Your answer
Are you currently working?
*
Yes
No
If YES, where are you currently working?
Your answer
Start date and pay rate of current job?
Your answer
Do you have transportation?
*
Yes
No
If YES, please explain your mode of transportation
Your answer
Indicate your level of education
*
GED
High School Diploma
Associate
Bachelor's or higher
Other
Work Experience | Last job? Please include how long you were employed, your title and rate of pay.
*
Your answer
Are you interested in On the Job Training?
*
Yes
No
Are you looking to work?
*
YES
NO
Full Time (40 hours)
Part Time (20 hours)
Flex Schedule
Weekdays
Evenings and Weekends
Other
Required
Have you ever been convicted of a crime?
Yes
No
Clear selection
Are you willing to travel for work?
Yes
No
Clear selection
What skills do you have?
Microsoft Office (Word, Excel, PowerPoint)
Web Design
Software/Computer
Manufacturing/Machinery
Accounting/Bookeeping
Customer Service
Retail
Food Service
Healthcare
Bilingual
Other skills you want to share
Your answer
What soft skills do you have?
Communication
Teamwork
Attention to detail
Flexibility
Time Management
Creativity
Other SOFT skill you want to share
Your answer
Do you have a resume?
Yes
No
It needs some work
Are you currently applying for jobs?
*
Yes
No
Yes, but I have limited resources
Are you looking for help with
Your resume
Connection with employers
Interviewing techniques
Understanding job descriptions
Building Self Confidence
Other:
Option 1
Clear selection
What resources do you need to help you maintain work?
Transportation
Childcare
Mentoring
Other
Other resources you need to help you maintain work
Your answer
**The EnVision Center | Regional Housing Authority reserves the right to distribute this form, your answers and contact information among other agencies at the Western Piedmont Council of Governments in an effort to best assist your family. Thank you.
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