Arkansas WIOA Screening & Application

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Eligibility Screening

Please complete the following form to determine potential eligibility for WIOA programs.

Date of Birth *

Gender *

Male

Female

Other

Prefer not to say

Are you legally authorized to work in the U.S.? *

YESNO

What is your current employment status? *

Employed Full-time

Employed Part-time

Unemployed

Self-Employed

Not in Labor Force

Have you been laid off, terminated, or notified of termination? *

YESNO

Are you currently receiving Unemployment Insurance (UI)? *

YESNO

Do you consider yourself low-income? *

Yes

Unsure

Do you receive any of the following public assistance benefits? *

SNAP

TEA

SSI

SSDI

Are you a U.S. Veteran? *

YESNO

Are you the spouse of a veteran? *

YESNO

Do you have any of the following barriers to employment? *

Homeless

Disability

Criminal justice involved

English not primary language

Foster care

Single parent

Single pregnant woman

Pregnant or parenting under 25

Unemployed over 27 weeks

Have you ever been involved in the criminal justice system (e.g., incarceration, probation)? *

YESNO

Have you worked as a seasonal or migrant agricultural worker in the past 12 months? *

YESNO

Do you identify as American Indian, Alaska Native, or Native Hawaiian? *

YESNO

Eligibility Screening

Complete the screening questions to determine your eligibility for WIOA programs.

Adult Program

Dislocated Worker Program

Youth Program

Job Corps

YouthBuild

Indian and Native American Program

Migrant and Seasonal Farmworker Program

Reentry Employment Opportunities

National Dislocated Worker Grant

Apprenticeship Program

Complete the screening questions to determine your eligibility.