Adult Participant Application - Rising Sun Center for Opportunity

Name

First Last

Date of Birth

Gender

Address

Street Address City ZIP / Postal Code

Address where you are currently staying (if different from above)

Street Address City ZIP / Postal Code

Primary Phone

Secondary Phone

Email

Alternate Email

Best way to contact you

Please indicate which class(es) you are interested in (choose all that apply)

Do you have a high school diploma or GED?

Are you able to attend the class for the scheduled dates and time?

Are you a United States citizen?

If not, can you provide documentation showing that you are legally eligible to work in the United States?

Do you have reliable transportation to and from training?

Have you ever been incarcerated?

Opportunity Build has resources available to support the re-entry population.

Do you have a valid driver's license?

Do you have access to a car?

Are you proficient in English?

Do you have a photo ID?

Are you an Oakland Housing Authority resident?*

If you have children, do you have reliable childcare?

How many people, including yourself, live in your home?

What is the total annual income of all residents of your home?

Please enter a number from 0 to 100000.

How did you hear about the Opportunity Build program?

Where did you see the presentation?

Name of person or organization that referred you