First Name: *
Last Name: *
Email Address: *
Confirm Email: *
Zip: *
Are you a Veteran?	No Yes
What are you interested in?: *
Employment status: *	Not Provided Employed Employed - Part Time Unemployed - Receiving Unemployment Compensation Unemployed - NOT Receiving Unemployment Compensation
Education: *	Some Highschool Highschool Graduate GED Some College Post-Secondary Certificate Associate's Degree Bachelor's Degree Post-Baccalaureate Certificate Master's Degree Post-Master's Certificate Doctoral Degree Post-Doctoral Training
Preferred Language:	English Español (Spanish) 中文 (Chinese)
Would you like to attend an orientation at the local Workforce New York office to learn more about using the Metrix Learning system?	Yes No
Would you be interested in accessing Medical, Production/Manufacturing or Prove It courses by visiting the Workforce New York Office?	Yes No
Do you want to speak to an Advisor regarding your job search?	Yes No
I have read and understand the Metrix Learning System Policies.
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