Assessment of Experience and Skills for Participation in the Section 3 Program

* 1. Please fill in the following:

* 2. I have children or dependents living with me.

* 3. If yes please list children's ages (If no leave blank)

* 4. Please select "I'm employed" if you are currently employed. If you are not employed, how long has it been since you've had a full-time job?

* 5. I have participated or am participating in a RHA Program: (Select all that apply)

* 6. I have participated in an employment or training program in the last 12 months state, local, or private: (Select all that apply)

* 7. What type of work are you interested in? You may list more than one.

* 8. What experience or skills do you currently have that will qualify you for your choice of work?

* 9. Do you have a resume?

* 10. Are there any barriers that interfere with your efforts to obtain a job. (Select all that apply)