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) Choose One... Alvord Banning Beaumont Coachella Valley Desert Center Desert Sands Empire Springs Harbor Springs Hemet Jurupa Lake Elsinore Menifee Union Murrieta Valley Nuview Union Palm Springs Palo Verde Perris Elementary Perris Union High RCEA RCOE River Springs Romoland San Jacinto Santa Rosa Academy Val Verde
A. Are you enrolled in Higher Education? Choose One... Yes No
If yes, select what you are enrolled in: Four-year college/university Community College Vocational or technical school (two year degree program)
B. Are you enrolled in some other postsecondary education or training program? Choose One... Yes No
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 Military training Incarcerated
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) Choose One... Yes No
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) Yes No
Submit
