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1. You must have an active registration (used in the past 90 days) in the Employ Florida Marketplace (EFM) at EmployFlorida.com to complete this pre-application. Please indicate the following:

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2. Enter your Employ Florida username.

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3. Enter your first name, last name and middle initial.

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4. Enter the last four digits of your Social Security number. XXX-XX-

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5. Enter your email address.

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6. Enter your phone number with area code. 

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7. Enter your address.

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8. What is your military status?

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9. Which branch of the military are you serving in/did you serve in?

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10. Are you a military spouse?

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11. Choose your training location.

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12. What is your program of study?

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13. Have you ever received training assistance from Workforce, Workforce Investment Act (WIA), or Workforce Innovation and Opportunity Act (WIOA) in the past?

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14. Have you lived in Florida for the past 12 months?

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15. Please indicate your marital status:

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16. Are you a citizen of the United State of America OR authorized to work in the USA?

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17. Please indicate your work status.

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18. What is your current employment status?

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19. What is your annual income?

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20. Do you work in your field of study?

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21. Are you currently enrolled in training?

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22. What is your household's approximate annual income?

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23. What is your primary language?

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24. Do you have an understanding of the English language?

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25. At any time, have you been convicted of the following:

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26. Please check the following if you are currently receiving assistance:

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27. Please indicate your highest completed education level.

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28. Do you currently have a driver's license?

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29. Which of the following driver's licenses do you hold?

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30. Do you have an occupational license?

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31. List 3 occupations in which you are currently seeking employment.

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32. List 3 occupations in which you are currently seeking employment.

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33. List 3 occupations in which you are currently seeking employment.

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34. Please list your last 3 employers, with the most recent being first.

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35. Please list your last 3 employers, with the most recent being first.

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36. Please list your last 3 employers, with the most recent being first.

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37. By typing your first and last name in the space below, you are indicating the information you have answered is correct to your knowledge.

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38. This Pre-Application in no way guarantees your acceptance as a participant under the CareerSource Training Center. You will need to be placed on a waiting list upon submission of a satisfactory, completed form. CareerSource will review your submitted Pre-Application to determine your eligibility and may contact you to schedule an appointment as funding becomes available. Please notify this office of any changes in your contact information, or if you no longer require training assistance.

By clicking the "I accept" box below, you are agreeing to allow CareerSource to access your previous education transcripts in order to determine your eligibility for a scholarship.

NOTICE: Information you provide to this agency is CONFIDENTIAL. However, information obtained by this agency about you may be provided to other state or federal agencies in the performance of their official duties according to Federal and State Statutes.

An Equal Opportunity Employer/Program. Auxiliary aids and services are available upon request to individuals with disabilities. All voice telephones may be reached by persons using TTY equipment via the Florida Relay Services at 711.

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