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* 1. What is your first name?

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* 2. What is your last name?

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* 3. Please fill out the information below:

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* 4. What is the best way to contact you?

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* 5. What are the best days and times to contact you?

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* 6. What is your English proficiency?

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* 7. What other languages do you speak?

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* 9. What type of transportation do you have?

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* 10. Do you have access to a laptop that you can bring to class every day? 

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* 11. What type of job are you looking for? Check all that apply.

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* 12. Which program dates work better for you?

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* 13. Are you willing to wear a mask during the training program to help prevent the spread of COVID-19?

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* 14. Do you have a case manager?

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