Apply Now Step 1 of 6 16% INFORMATION REQUIRED FOR FEDERAL REPORTING UNDER THE PRE APPRENTICESHIP PROGRAM. Information disclosed will only be shared with your referring agency and any other entity that requires the information.COMPLETING THE APPLICATION WITH THE MOST ACCURATE AND UP-TO-DATE INFORMATION WILL ASSIST SOCAL IN IDENTIFYING TUITION ASSISTANCE OPPORTUNITIES. (APPLICANT):Your Email(Required) Personal InformationYour Name(Required) First Middle Last Enter Last 4 digits of Social Security Number(Required)You will need to provide your full social security number during your intake review process. Date of Birth(Required) Age(Required)Please enter a number from 16 to 99.Gender(Required) Male Female Non-Binary Other Prefer not to say Race / Ethnicity(Required)Check all that apply American Indian or Alaska Native Asian African American / Black Latino Native Hawaiian or Other Pacific Islander Caucasian Are you of Hispanic, Latino, or Spanish Origin?(Required) Yes No Preferred Language used in the Household: English Spanish French Korean Chinese Vietnamese Tagalog Arabic Other Do you speak English as a second language? Yes No Current Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Contact Preference Phone Email Both Name of Emergency Contact(Required) First Last Phone Number(Required)Relationship(Required) Eligibility RequirementsHave you watched the applicant program overview video on the SoCal website.(Required)(Note: if you have not, please watch the video before completing this application.) Yes Are you a United States Citizen? *(Required) Yes No Are you a permanent resident?(Required) Yes No Not Applicable Do you have a valid Government issued ID?(Required) Yes No Which form of Identification?(Required) Drivers License State ID Permanent Resident Card Military ID Passport Are you a Veteran?(Required) Yes No Can you provide your DD Form 214, Certificate of Release or Discharge from Active Duty?(Required)Select N/A if you are not a veteran. Yes No N/A If you are a Veteran what is your discharge status?(Required) Do you have internet access?(Required) Yes No Educational Goals / Work HistoryDo you have a high school diploma or GED?(Required) Yes No What is the highest level of education you completed?(Required) What are your educational goals? Are you currently working?(Required) Yes No If employed are you part-time or full-time?(Required) Part-time Full-time What are your career goals?(Required) Please list some of your strengths, skills, abilities, and or interests that will help you reach your goals:What challenges have you experienced in the past when accomplishing your goals?What Trade Industries are you interested in? Select All that apply: Brickmasons, and Stonemasons Construction and Building Inspectors Construction Laborers Electrician Plumbing and HVAC Solar IT Coding Other What are your GOALS upon completion of the SoCal Pre Apprenticeship Program?(Required) Economic and Social Impact QuestionsHow did you hear about SoCal Pre Apprenticeship?(Required) Social Media Website Flyer Workforce Partnership / Career Center/ American Job Centers of America SoCal Alumni Participant Friend / Family Member Employment Program Social Services Agency (CalFresh, SNAP, CAAP, Medi-Cal) Community Resource Apprenticeship San Diego Reader or Voice and Viewpoint Probation or Parole Other Do you have a Case Manger?(Required) Yes No What is their name?(Required) First Last What is their phone number?(Required)If you are currently receiving CalFresh, in which county? Current Living Situation (select those that apply):(Required) Own Rental (no subsidy) Rental (with subsidy) Rental (VASH) Staying with Family or Friends Emergency Shelter Foster Care Hotel / Motel Transitional Living At-Risk of Homelessness Experiencing Homelessness Displaced Marital Status:(Required) Single Married Domestic Partner Do you have dependents, children, or someone you care for?(Required) Yes No Do you have reliable transportation? Yes No Do you need a bus pass? Yes No Maybe Have you been impacted by an incarceration?(Required) Yes No Was the incident within the last 7 years?(Required) Yes No Do you have a probation or parole officer?(Required) Yes No Parole / Probation Officer's Name(Required) First Last Parole / Probation Officer's Phone Number(Required)Probation/Parole Officer Email Address Certification of InformationI certify that all the information provided is accurate and true to the best of my knowledge. I understand that false information may be grounds for contained in this application is true and complete. I understand that falsified statements on this application in any detail shall be considered sufficient cause for disqualification from further consideration into the program. I also acknowledge there is a tuition cost associated with enrolling in the SoCal Pre Apprenticeship Program:Do you agree that all the responses above are true and correct?(Required) Yes No HiddenDate Completed(Required) MM slash DD slash YYYY Untitled Untitled First Choice Second Choice Third Choice NameThis field is for validation purposes and should be left unchanged. Δ
