FORM P-001

NAME

DATE OF BIRTH

ADDRESS

TELEPHONE

EMPLOYMENT STATUS

ARE YOU AVAILABLE TO START IMMEDIATELY?

EMPLOYER

JOB DESCRIPTION

CERTIFICATIONS / TRAINING

SKILLS ASSESSMENT

SKILL(S) PROFICIENCY LEVEL

Beginner Intermediate Advanced

PREFERRED WORK SCHEDULE

ADDITIONL ABILITIES

ARE YOU INTERESTED IN LEARNING NEW SKILLS OR TRAINING PROGRAM?

Yes No

IF YES SELECT AREA(S)

OTHER

REFREENCES

I HEREBY DECLARE that the information provided is true and accurate to the best of my knowledge. I UNDERSTAND that this form may be used for employment matching, training opportunities, and workforce development programs. I CONSENT to the Office of E. P. Chet Greene contacting me regarding job opportunities, training programs, and related services via phone, email, or SMS. I AGREE to receive updates and alerts related to employment opportunities and programs. I confirm that I have read, understood, and agree to the above terms and conditions.

Employment & Skills Assessment