Jobs, Education, Training Program Initial Information Form

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To be eligible for the Jobs, Education and Training Program, you must:
· Be between 17-24 years old as of July 1, 2020
· Live in the Eastern Connecticut Region
· Be eligible to work in the United States
· Not be attending any school
· Meet income eligibility requirements

For more information about the 2020 JET Program please fill in the pre-application below.

As a public, non-profit, Regional Educational Service Center, and Employment and Training Provider, EASTCONN is bound by Connecticut state student-privacy laws, which prohibit the use of student information for any purpose other than the student intends, and the Personal Identity Information Policy contained within the Connecticut Department of Labor Workforce Innovation Opportunity Act Manual. All information collected here, both from students and non-students, will be used solely for the purpose of enrollment in the 2020 EASTCONN Jobs, Employment and Training Program, and will not be shared or used for any other purpose.

Email *

I acknowledge that I have read the statement above and I give my permission to provide Personal Identifiable Information below. *

Yes

First Name: *

Last Name: *

Phone number, including area code. Example: 860-555-5555 *

Town of Residence: *

Do you attend school?

Yes

Other:

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How did you hear about the JET Program?

EASTCONN Website

EASTCONN Facebook Page

American Job Center

Brochure/ Flyer

Newspaper

3rd Thursday

Family Member or Friend

Other:

A copy of your responses will be emailed to the address you provided.

Submit

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