Applicant Pre-Screening Form

Barriers to Employment (check all that apply)
Please note that funding is available for all or most of these situations. Your answers help us see what programs you may be eligible for and will be held in the strictest of confidence.














Select which one applies to you right now

Complete all information if known. If not, leave blank.

The grant programs we offer provide financial assistance for individuals who want to improve themselves through training and employment. In a paragraph or two, please tell us a little about yourself, your career goals, and how these programs can help support you in successfully accomplishing your goals. Use this opportunity to provide as much detail about yourself and what you’ve had (or will have) to overcome to achieve your dreams.

(Required)

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






The NR/MR Workforce Development Board is an Equal Opportunity Employer/Program. Auxiliary Aids and Services are available upon request to individuals with disabilities.