The Dalles Pre-Apprenticeship Interest Form

First Name *

Last Name *

Email *

Phone *

Can we text you? *

Yes
No

City *

County *

Gender *

Race *

White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Two or more races

Ethnicity *

Hispanic or Latino
Not Hispanic or Latino

Do you self-identify as BIPOC (Black, Indigenous, or Person of Color)? *

Yes
No

Do you receive SNAP Benefits? *

Yes
No
Unsure

Referred by...

I want more information... *

because I am interested in participating in the training
because I am a professional helping individuals with their training/employment goals

If you are a professional helping a client, please tell us your title and affiliation:

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