Platform to Employment (P2E) Application
RequiredRequired Question(s)

P2E is open to those who have exhausted their unemployment benefits:

 

Please complete this application. Answer all questions, including contact information. If selected to move to the next level in the process, you will receive an email to set up a telephone interview. Only participants who receive emails will be considered for advancement. Please do not call to inquire about your application status. A confirmation page will display once you have completed the application.

 

 
Required 1.

Please enter the information indicated below. Under Phone 2, please list your mobile number if applicable



First Name:
Last Name:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:
Phone 2:

2.

This program is open to people age 50 or older or Veterans who are 30 years of age and younger. Please indicate your age below.

18-24
25-29
30-39
40-49
50-59
60-69
70 and over
Required 3.
What is your sex? 
Male
Female
Required 4.

 Are you a Veteran?

Yes
No
Required 5.

What is your unemployment benefit status?

Currently Collecting
Exhausted My Benefits
Have Not Received Benefits
Required 6.

 

How long have you been unemployed?

1-3 months
4-6 months
7-12 months
13-18 months
19-24 months
24-29 months
30- 36 months
37-42 months
More than 43 months
Required 7.

Do you have any means of income in addition to unemployment insurance (select all that apply)? 

Social Security
Pension
Disabilty
Alimony
Savings/Investments
Spouse/Other household adult
Other  
Required 8.

What is your current total annual household income from all sources?

 

50 characters left.
Required 9.

What is your household size? 


1
2
3
4
5 or more
Required 10.
Is there another adult in your household (over 21) who is employed? If yes, are they employed full-time or part-time?
Yes. If yes, indicate below if it is part-time or full-time.
No
  • Comment:

  • 500 characters left.
Required 11.

 State the name of your last full-time employer,  your job title and last date of work.  

 

1000 characters left.
Required 12.
Tell us briefly about your most recent separation from your employer.
 

1000 characters left.
Required 13.
How long were you employed in your last position?
 

50 characters left.
Required 14.

What was your primary occupation?

Architecture and Engineering Occupations
Arts, Design, Entertainment, Sports, and Media Occupations
Building and Grounds Cleaning and Maintenance Occupations
Business and Financial Operations Occupations
Community and Social Services Occupations
Computer and Mathematical Occupations
Construction and Extraction Occupations
Education, Training, and Library Occupations
Food Preparations and Serving Related Occupations
Healthcare Practitioners and Technical Occupations
Healthcare Support Occupations
Installation, Maintenance, and Repair Occupations
Legal Occupations
Management Occupations
Office and Administrative Support Occupations
Personal Care and Service Occupations
Production Occupations
Protective Service Occupations
Sales and Related Occupations
Transportation and Material Moving Occupations
Other  
Required 15.

What were your annual earnings from your previous employer?

$0 to $10,000
$10,001 to $20,000
$20,001 to $30,000
$30,001 to $40,000
$40,001 to $50,000
$50,001 to $60,000
$60,001 to $70,000
$70,001 to $80,000
$80,001 to $90,000
$90,001 to $100,000
More than $100,000
Required 16.

 What is the highest level of education you completed?    

Did not complete high school
High School Diploma/GED
Associate Degree
Bachelor
Masters
Doctorate
State Recognized Apprenticeship Program
Required 17.

What types of jobs have you submitted an application for? (Select up to 3 choices) 

Architecture and Engineering Occupations
Arts, Design, Entertainment, Sports, and Media Occupations
Building and Ground Cleaning and Maintenance Occupations
Business and Financial Operations Occupations
Community and Social Services Occupations
Computer and Mathematical Occupations
Construction and Extraction Occupations
Education, Training, and Library Occupations
Food Preparations and Serving Related Occupations
Healthcare Practitioners and Technical Occupations
Healthcare Support Occupations
Installation, Maintenance, and Repair Occupations
Legal Occupations
Management Occupations
Office and Administrative Support Occupations
Personal Care and Service Occupations
Production Occupations
Protective Service Occupations
Sales and Related Occupations
Transportation and Material Moving Occupations
Other  
Required 18.

If you have a professional license, please describe the the type. 

 

50 characters left.
Required 19.
Do you have a current résumé?
Yes
No
Required 20.

How many job offers have you turned down since becoming unemployed? Please explain why any offers of employment were declined.

0
1
2
3
4
5
  • Comment:

  • 500 characters left.
Required 21.

How many hours a week do you spend seeking full-time employment?

Less than 8
9-16 hours
17-24 hours
25-32 hours
33-40 hours
40+ hours
Required 22.
How many job interviews have you had in the past 6 months? Count in-person and telephone interviews.
 

50 characters left.
Required 23.

How often do you use the following resources during your job search?

 Never Not Often Sometimes Regularly  
Job Search Websites  
Placement Agencies  
Cold Calling  
Professional Network  
Personal/Social Network  
Employee Referrals  
School Alumni Groups  
Required 24.

If you were offered a full-time position, what starting salary would be acceptable?

Less than $20,000
$20,001 to $30,000
$30,001 to $40,000
$40,001 to $50,000
$50,001 to $60,000
$60,001 to $70,000
$70,001 to $80,000 +
Required 25.

How far are you willing to travel for work (one-way)?  

0-20 miles
21-30 miles
31-60 miles
Required 26.

What is your primary means of transportation?  

Bus
Car (own)
Car (relative/friend)
Train
Walk
Other  
Required 27.

 Have you ever received services at a OneStop Career Center? If so, what type of service(s). Select all that apply.

  

Occupational Skills Training
Job Search Assistance
Community Program
Computer Lab
Workshop
Have Not Received Services
Required 28.

During this period of unemployment, have you returned to school or taken further training. If the answer is yes, please explain the academic program or training.

Yes
No
  • Comment:

  • 500 characters left.
Required 29.

Please describe any volunteer service, unpaid internships and/or other activities you have been engaged in during this period of unemployment?  



 

350 characters left.
Required 30.
Do you have a computer and access to the Internet at home?
Yes
No
Required 31.
Are you currently registered with LinkedIn to assist in your job search?
Yes
No
Required 32.
Do you have experience using Skype or other video conference software? (Skype is video conference feature for computers and mobile phones)
Yes
No
Required 33.

Are you willing to conduct cold calls to potential employers on a weekly basis?

Yes
No
Required 34.
How many cold calls per week do you currently make to prospective employers?
 

50 characters left.
Required 35.
Do you agree to continue to be active in your job search while in the program and document your job search efforts on a weekly basis?
Yes
No
Required 36.

P2E is an intensive five week training course that brings mental health and financial education services to assist job seekers. Upon completion you will be assisted in your job search and potentially placed with an employer who will be eligible to receive a wage subsidy. Tell us briefly your motivation to participate in this program as well as your expectations.

 

1000 characters left.
Required 37.
Briefly tell us about yourself. (Think of us as an employer...what would you want us to know about you.)
 

1000 characters left.
Required 38.

Tell me about yourself (think of your 30 second commercial), also known as the elevator speech. 


 

1000 characters left.
Required 39.

What motivates you?


 

1000 characters left.
Required 40.

What do you expect to get out of the Platform to Employment program?


 

1000 characters left.
Required 41.

At this stage in your life, what are your career goals?


 

1000 characters left.
Required 42.

Job search is about effort, planning and accountability.  What are you doing to achieve your goals?


 

1000 characters left.
Required 43.

What were two of your biggest accomplishments in your last position and how did they impact your employer? 

 

1000 characters left.
Required 44.

What are your weaknesses as they relate to job search? What are you doing to improve in these areas?


 

1000 characters left.
Required 45.
Tell me about a time when you had to demonstrate leadership skills and take initiative?
 

1000 characters left.
Required 46.

You have been unemployed for some time, why do you believe your job search has been unsuccessful? 

 

1000 characters left.
Required 47.
Describe a time when a former manager offered you constructive criticism.  How did you handle the situation and what did you do about it (who, what, where, when, why)?
 

1000 characters left.
48.

What is your race? 

African American/Black
Hispanic/Latino
Caucasian/White
Asian
American Indian/Alaska Native
Non-Hispanic
Native Hawaiian/Other Pacific Islander
Other