Project E.A.T. Application Question Title * 1. Name Question Title * 2. Email Address Question Title * 3. Phone Number Question Title * 4. Are you currently employed Yes No Question Title * 5. Are you currently receiving any of the following? Select all that apply. TANF Food Stamps Medicaid Unemployment Insurance Disability SSI Question Title * 6. Are you interested in working in manufacturing, logistics/distribution? Yes No Question Title * 7. What is your Age as of today? Under 18 18-24 25-34 35-44 45-54 55-64 65+ Question Title * 8. What are your barriers to work? Child Care Housing Food Transportation Overall ability to pay my bills Question Title * 9. What do you hope to get out of the program? Question Title * 10. Address Done