Warehouseman Training Inc

Pre-Registration for
Warehouseman Training Classes

  Last Name
  First Name

  Last Four SSN


  Apt #


  Home Phone
  Cell Phone


Female    Male    Undisclosed

On Parole or Probation:
Yes    No

Following Questions to determine Sponsor (funding)

Yes    No

Youth (17-24):
Yes    No

Dislocated Worker:
Yes    No

Drug and Alcohol Treatment:
Yes    No

Non-Custodial Parent:
Yes    No

Recieving Food Stamps:
Yes    No

Recieving Unemployment:
Yes    No

Own a Vehicle:
Yes    No

HS Diploma    GED/HiSet

Have you ever worked with Vocational Rehab (VR):
Yes    No

How did you hear about the Program / Comments