ACHIEVE Eligibility Questionnaire

Introduction

Thank you for your interest in participating in ACHIEVE! ACHIEVE is a collaborative project led by the Lancaster County Workforce Development Board to support you as you consider returning to complete your degree or credentialing program.

Partners of ACHIEVE include Millersville University of Pennsylvania, a Pennsylvania System of State Higher Education (PASSHE) institute, Elizabethtown College, Pennsylvania College of Art and Design (PCAD), the Lancaster Chamber, and PA CareerLink® Lancaster County.

Equal Opportunity Program/Employer. Auxiliary aids and services available upon request to those with disabilities.

Program funded with federal dollars. For detailed information see https://www.lancastercountywib.com/organizational-integrity/operating-documents/

Below you will find a series of questions which will help determine your eligibility for participation.

En Español: https://www.surveymonkey.com/r/SLCDCRR

Question Title

* 1. Please enter the following contact information:

Name *

Company, if applicable

Address *

Address 2 *

City/Town *

State/Province *

ZIP/Postal Code *

Email Address

Phone Number *

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* 2. Please enter your date of birth.

DOB

Date

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* 3. Which race/ethnicity best describes you? (Please choose only one.)

American Indian or Alaskan Native

Asian / Pacific Islander

Black or African American

Hispanic

White / Caucasian

Prefer not to answer

Multiple ethnicity / Other (please specify)

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* 4. Which of the following options most closely aligns with your gender?

Woman

Man

Non-binary

A gender not listed here

Prefer not to answer

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* 5. Are you a veteran?

Yes

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* 6. What is your area of interest/program focus/field of study?

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* 7. Please select which postsecondary institution you would like to consider enrolling in:

Millersville University

Elizabethtown College

PA College of Art & Design (PCAD)

Unsure

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* 8. Please select any and all barriers that have prevented you from program/degree completion and/or employment opportunities:

Childcare

Housing

Transportation

Access to/affordability of educational supports

Limited career readiness skills

Elder care

Access to/affordability of technology/broadband

Access to employment opportunities or work-based/experiential learning

Access to/affordability of appropriate language supports

Other (please specify)

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* 9. Please select an option for the following statement: I am interested and able to pursue employment with the intention of becoming employed within 12-months of education program completion if currently unemployed or dislocated from employment.

I am currently employed in a position within my degree/certificate interest area.

I am currently employed but I am not in a position within my degree/certificate interest area.

I am interested and intend on pursuing employment following the program completion.

I am not interested in pursuing employment after program completion.