Here are ways we can help:

Career counseling and job search assistance:

Our Career Navigators, in Gadsden, Jefferson, Leon and Wakulla counties, are ready to help you customize your employment portfolio to appeal to local employers. We’ll help you with each step you take to secure your next job.
 

Complete this form to connect with a Career Navigator.

First Name *

Last Name *

Middle Initial

Last 4 Social Security #

Please use numbers only

Disclosure of the last four digits of your social security number is voluntary. It is requested however, pursuant to Privacy Act of 1974. Social security numbers will be used by CareerSource Capital Region for the sole purpose of system review to determine our overall level of efficiency.

Address

Street Address

Address Line 2

City

State / Province / Region

Zip / Postal Code

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County (Must live in Gadsden, Jefferson, Leon or Wakulla to qualify) *

•   Gadsden
•   Jefferson
•   Leon
•   Wakulla

Email *

Cell Phone or Home Phone *

Area Code

Phone Number

Alternate Contact Number

Area Code

Phone Number

What type of career are you most interested in?

•   Retail, Hospitality, Education, or General
•   IT, Professional, or Human Services
•   Health Care
•   Manufacturing, Construction, Transportation, and Logistics
•   Other
•   Not Sure

If applicable, which organization referred you to this Pre-Application or the WIOA program?

Please complete the following questions to help us determine your potential eligibility for the WIOA program. The more accurate the information you provide, the easier it will be for us to enroll you in our program. All of the information collected is confidential.

Are you a US Citizen, Naturalized Citizen, or are you a legally admitted alien or refugee? *

•   Yes
•   No
•   N/A

Are you a veteran who has served at least 180 days on active duty or a spouse of a veteran? *

•   Yes
•   No
•   N/A

Males 18 yrs. old or older only: Are you registered with Selective Service? *

•   Yes
•   No
•   N/A

What is the highest level of education that you have achieved? *

Currently in GED/ABE Classes Dropped out of High School Currently in High School High School Graduate Currently in a Vocational or Apprenticeship Program Graduated from a Vocational or Apprenticeship Program Currently in College College Graduate - Associate's, Bachelor's, or Master's Degree

Do you receive Re-employment assistance? *

•   Yes
•   No
•   N/A

Have you exhausted your Re-employment assistance? *

•   Yes
•   No
•   N/A

Are you currently receiving a TANF grant? *

•   Yes
•   No
•   N/A

Are you currently receiving food stamps or have you received food stamps in the last 6 months? *

•   Yes
•   No
•   N/A

How Did You Hear About This Program?

•   Staff Person
•   CareerSource Capital Region Website
•   Referral from Another Agency / Organization
•   Advertisement/Public Notices (Radio, Local News, SmartTV/Connected TV, etc.)
•   Social Media (Meta - Facebook/Instagram, TikTok, or Linkedin)

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