OSY Youth Workforce Center Interest Form
Greetings prospective students! Thank you for your interest in the Youth Workforce Center Out-of-School Program. Please complete the following questionnaire. Our Fall classes have started. We will reach out to you when the Spring Schedule is released.

The Youth Workforce Center is an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. VA Relay: 711. The Youth Workforce Center is funded 100% through WIOA Title I funds via an award made to NHREC via HRWC via pass through entity VCCS.
Email *
First and Last Name *
Date of Birth ( Month, Day, Year) *
MM
/
DD
/
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Phone Number *
Full Current Address (including city and zip code) *
Occupational Skills Training Interest  *
Do you have a high school diploma or GED? *
Required
Do you have children? *
Have you worked in the last 6 months?  If yes, were you full or part time? *
Required
If employed how much did you earn per hour? If no, write NA *
Are you currently in foster care or aged out of foster care? *
Do you receive any of the following benefits? *
Required
Have you been arrested or charged with an offense other than a minor traffic infraction? *
How did you hear about us? *
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