Pre-Assessment Form

Apply Today and Start Exploring Your Career Options

Santa Cruz County One Stop assists local youths in Southern Arizona with furthering their education, exploring their career options, acquiring job skills, and building a customized career pathway toward lasting success. If you are a youth in Santa Cruz County, we invite you to explore your eligibility for our two youth services programs: the Out of School Youth program and the In-School Youth program.

The Out of School Youth program is intended for young people ages 16 to 24 who have either dropped out of school or who have graduated from high school, but have not pursued post-secondary education. Our In-School Youth program is intended for youths who are still in high school, yet at risk of dropping out. We aim to empower youths by helping them complete their education or high school equivalency (HSE), and guiding them in acquiring job skills as they explore their career options.

You can use the application here to apply for either of our youth programs. Acceptance is dependent on eligibility. The submission of this form is not a guarantee of eligibility or program participation.

"*" indicates required fields

Workforce Innovation & Opportunity Act Participant Pre-Assessment

Submission of this form does not guarantee eligibility or program participation

Applicant Information - Please Print; ALL INFORMATION REQUESTED MUST BE COMPLETED

Today's Date

Applicant's First Name*

Applicant's Last Name*

Date of Birth*

Address*

Street Address City State ZIP Code

Phone*

Email*

Preferred Contact Method

Are you a U.S. Veteran?*

Yes

Do you have a U.S. high school diploma or GED®?*

Yes

Are you interested in obtaining a GED?*

Yes

What services are you inquiring about on todays visit? (You can pick more than one)

Agreement*

By signing this form, I hereby acknowledge that I was provided information on the services available through the Santa Cruz County Workforce Development, a program funded through the U.S. Department of Labor Workforce Innovation & Opportunity Act. I agree that all information contained herein is true and to the best of my knowledge. I authorize the Santa Cruz County Workforce Development program to verify any information contained on this form, and I understand that any falsification or misstatements made to obtain eligibility and/or benefits may be subject to termination of consideration for the program. Title I Workforce Innovation & Opportunity Act programs are not an entitlement and training services requests will be evaluated on a case-by-case basis and funding availability. This form will consider your income level and other factors to determine your eligibility; not all eligible applicants are approved for WIOA funding. Submission of this application does not guarantee eligibility or program participation.

Applicant's Signature*

Name

This field is for validation purposes and should be left unchanged.

Have Questions? Get In Touch With Our Team

At Santa Cruz County One Stop, you can continue your education, master the English language, develop a customized career pathway, receive job placement assistance, and much more! All you have to do is take the first step. Contact us today to begin working toward a better tomorrow.

Pre-Assessment Form

Apply Today and Start Exploring Your Career Options

Workforce Innovation & Opportunity Act Participant Pre-Assessment

Submission of this form does not guarantee eligibility or program participation

Have Questions? Get In Touch With Our Team

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