Manufacturing Pre-Apprenticeship Preparation Training Date* Month Day Year Name* First Last Date of Birth* Month Day Year Do you have an SSN?* Yes Yes but I don’t have a card No SSN*Confirm SSN*Email* Confirm Email* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Phone*Primary Phone Type* Mobile Home Work Message Only Alternate PhoneAlternate Phone Type Mobile Home Work Message Only How did you hear about this program?* Email Social Media Family or Friends American Job Center Organization Website Nonprofit/Faith-based organization referral Mailings Newspaper or Magazine Radio TV Other Are you interested in working in manufacturing or the building trades?* Yes No Which of the following manufacturing industries are you interested in learning more about?* Computer Assisted Drafting/3D Printing Precision Machining/CNC Operations Heating, Ventilation, and Air Conditioning (HVAC) Welding Manufacturing Trades Electrical Industrial Maintenance Other Check all that applyIf Other*Are you interested in applying for an apprenticeship program?* Yes No Are you willing and able to put in the time required by this program?* Yes No What sex were you assigned at birth, on your birth certificate?* Male Female Prefer not to answer How do you currently describe yourself?* Male Female Transgender I use a different term Prefer not to answer Are you authorized to work in the US?* Yes No What racial or ethnic groups best describe you?* Native American or Alaskan Native Asian Black/African American Hawaiian or Pacific Islander Hispanic or Latino White Prefer not to answer Select all that applyVeteran Status* None Active Veteran Discharged Prefer not to answer Have you ever been incarcerated for a felony or misdemeanor?* Yes No Prefer not to answer Have you had prior involvement in the criminal legal system?* Yes No Prefer not to answer Are you a graduate of foster care or currently in foster care?* Yes No Prefer not to answer Are you a displaced worker?* Yes No Prefer not to answer Do you have other barriers to employment?* Yes No Prefer not to answer Do you have a high school diploma, General Education Development (GED) certificate, or High School Equivalency Diploma (HiSED)?* Yes No – I am in high school No – I am in a program working toward a high school diploma, GED, or HiSED No CAPTCHA Helpful Links Career & Employer Services Learn More Services Learn More Contact Career Services Learn More NOW HIRING Learn More Events Learn More Illinois workNet Learn More Free Training with WIOA Learn More
