Intake Form for Emergency Assistance Shelter Training Programs

 
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Name
Please select your sex:
Do you identify as Hispanic or Latino?
What race do you identify as?
Address
Primary Language
Other languages you can speak and understand
Are you living in an emergency shelter?
Are you being supported by a resettlement agency?
Are you currently taking English classes?
Are you currently employed?
What training program are you enrolling in?

MassHire Central Career Centers would like to record your information in our database, as well as share your resume and information with employers on your behalf. We may also share information with any resettlement agency that is supporting you. By submitting this form, you give MassHire Central Career Centers permission to record your information in our database, as well as share your information with employers and MassHire partners supporting those migrants living in emergency shelters. Your information may be used in aggregate with other program participants, and your personal information such as your Social Security number will only be shared with other government agencies such as the State of Massachusetts. MassHire Career Centers are not involved or communicating with or connected to any law enforcement agencies.