Please fill out the very short survey:
What is your first name?
What is your last name?
What is your date of birth? (mm/dd/yyyy format please)
Which district did you last attend? (Please select only one)
Perris Union High
Santa Rosa Academy
A. Are you enrolled in Higher Education?
If yes, select what you are enrolled in:
Vocational or technical school (two year degree program)
B. Are you enrolled in some other postsecondary education or training program?
If yes, check what you are enrolled in:
General Education Development (GED) Program
Vocational or Technical school certificate program
Regional Occupation Program (ROP) Classes
Workforce Investment Act (WIA) supported program
Non-Workability employment program
Adult training program
C. Are you competitively employed? (i.e., work for pay at or above the minimum wage and work with others who are non-disabled, OR, self-employed and work an average of 20 or more hours per week)
D. If you answered “No” to question C above, are you in some other type of employment? (e.g., work in sheltered or other type of supported employment)