Goodwill/Stride Center A+ Computer Repair Program

To be considered as a prospect for The Goodwill-Stride Center Program fill out the following application.

ADMISSION REQUIREMENTS:

To qualify for The Stride Center workforce development program the applicant must:

1. Be 18 years of age

2. Be a resident of California

3. Provide proof of age, residence and income

4. Provide proof of education (Diploma or transcripts -- HS, GED or College)

5. Take a TABE exam and a computer assessment admission test at our location (call to make an appointment 510-234-1300ext 126)

6. Write a 400 word essay describing the following:

a)Introduce yourself

b)Describe why you would be a qualified candidate for this program

c)Describe your level of commitment to complete this program

d)Make a statement that you will be seeking gainful employment once you complete the program

Click HERE to create an account or if you are a returning user (This feature will allow you to save your application and return to it later)

www.stridecenter.org

510-234-1300 ext 126

Student Information

First Name *

MI

Last Name *

Home Phone

Cell Phone (000)000-0000

Best time to contact you *

Email Address

Birthdate mm/dd/year *

Social Security #

ID Number *

I.D. Type *

Street Address *

Apt Number

City *

State *

Postal Code *

Residence Status *

Marital Status *

Shirt Size * 🛈

Which location are you interested in taking classes?

Save & Return Account (optional)

New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish. The account you establish is only for this form.

Demographics

Race / Ethnicity *

Race / Ethnicity .. if not listed

Gender *

Gender ... if not listed

How did you hear about The Stride Program? *

If other tell us where

Criminal Record *

If Yes to Criminal Record choose one

Size of Household *

Are you the Head of household *

Income Size *

Do you receive income from any of the following?

If other please clarify

Are you homeless? *

If homeless and in a shelter please provide name, address and phone number of the shelter contact person

Are you currently working? *

No

Yes

Do you have issues with substance abuse in the present? *

Are you 62 Years of older? *

Do you have a California ID? *

Save & Return Account (optional)

New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish. The account you establish is only for this form.

Was your job lost to because it was outsourced outside the United States?

Do you have an unemployment claim? * 🛈

Are you a dislocated worker? * 🛈

Are you currently receiving unemployment? *

Do you have a documented disability? *

Are you a US Veteran? *

Are you receiving V.A benefits?

Emergency Contact Information

Emergency Contact Full Name

Emergency Phone

Emergency Contact Email Address

Case Manager Information

Do you have a case manager? * 🛈

Full Name of Case Manager

Phone number of case manager

Address of case manager

Email Address of Case Manager

Save & Return Account (optional)

New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish. The account you establish is only for this form.

In your own assessment, what is your knowledge of computers? * 🛈

Do you have a computer at home? *

Do you have access to the Internet? *

Are you facing any or multiple of the following challenges?

Academic Records

Education *

School Name *

Graduation Date +

Save & Return Account (optional)

New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish. The account you establish is only for this form.

Previous Career

Do you have a previous career in a different field? *

If yes please specify

Do you have previous experience in the information technology field? *

List any related industry certifications you have

Please list any sports, extracurricular, or community service activities that you have participated in

Write a 250 word essay. Describe the following: Introduce yourself -- Level of commitment you are willing to make to complete the program -- Describe you dedication to passing the course and passing the certification -- Make a statement that you will seek gainful employment in the IT field -- Describe any relevant previous experience certifications you have -- 🛈

Signature

I certified that all the information and statements in this application are true and correct to the best of my knowledge. I further agree to abide by all the procedures related to the application and enrollment at The Stride Center. * 🛈

clear

Save & Return Account (optional)

New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish. The account you establish is only for this form.

Driver's License	State I.D.
Passport	EAD Card
Matricular Consular Card	U.S.A._Permanent Residence

Transportation	Unstable housing	Child care
Drug addiction	Medical condition	Contact with the justice system
Lack of confidence	Mental health issues	Emotional instability
Other Other

Asociates Degree	Bachelors	Below 12TH Grade
CHSTPE	Doctorate	GED
GED in progress	Graduate	High school diploma
Masters degree	Some College