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Application for Spring '08 Vocational Classes

Name: _____________________________________________________

Street/City: __________________________________________________

Zip: _______________________ Phone: __________________________

Email: ______________________________________________________

Do you have a disability of any sort?         Yes ___ No ___
Are you receiving Medicaid?                      Yes ___ No ___
Do you have a Ticket to Work?                  Yes ___ No ___
Are you on SSI? SSDI?                              Yes ___ No ___
Are you on VR (Voc Rehab)?                     Yes ___ No ___  Pending ___

       Counselor's name: ___________________

Are you receiving TANF?                            Yes ___ No ___  

             Worker's name: ___________________

Are you on the Foster Care

    Independent Living Program?                 Yes ___ No ___

Have you used our services before?          Yes ___ No ___

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Program Applied For (please choose only 1):

• Office Assistant ___  
  (Meets Tue through Fri, 8:30 - 10:20 AM, Jan 15 - May 9, 2008)  
  Fee: $1500
  

• Information Technology Careers II ___  
  (Meets Saturdays, 12 - 4 PM, Jan 12 - May 10, 2007)  
  Fee: $1350

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Please rank your computer skill/knowledge level from 0-10 in the following areas,
with 0 being no skill and 10 being expert.

Please be as realistic as possible — if you say you have the basic skills necessary and you really don’t, you will fail the class because you won’t be able to do the work.  Please sign up for our basic classes first and then apply for the vocational class.  

For example, people who have completed our Intro to Word class and that’s the only word processing they’ve done are about a “4”.  A “10” would be someone who could quickly create an annual report with photos, tables, graphs, headers and footers, footnotes, hyperlinks, data linked directly from Excel  and then use mailmerge to pull names and addresses from a database, insert them into the appropriate places in a cover letter, and print address labels to send the whole thing off.  Can you do that?

 (please fill out)

Please answer the following questions as completely as possible — use extra paper if you wish.  

I.      Please describe what computer experience you have such as classes you’ve taken, games you’ve played, software you’ve used, software/hardware you’ve installed, and how many hours of each:

II.       Please describe any work or volunteer experience you’ve had:

III.      What are you looking for in a job?  What will you bring to a job?

IV.    Our classes are designed for people with varying disabilities.  What assistance will you need, if any?  What restrictions need to be taken into consideration, if any?

V.      Why do you wish to enroll in this vocational program?