Confidential Survey

ManifestWorks is a workforce development and job placement organization, so you must be eligible for work upon submission of your application. 

The information in this survey will be kept confidential – it is for our internal purposes only.

None of the information that you provide will affect or limit your acceptance, so please be honest with your answers so that we can best serve you. 

Please note: questions marked with an asterisk* require an answer.

Name *
Write a few sentences:
I have a strong network of people who are making a difference in my career. *
I am proud of my career. *
I feel like my past will continue to get in the way of me being successful in the future. *
Currently I make a financial contribution to my family. *
Currently I am able to provide for myself without relying on other people, the government or charity.
What's your current living situation? *
Are you currently on *
If so, are you able show a copy of your DD214? (Discharge status will not disqualify you from admission)
If so, approximately when?
If so, approximately when?
If so, please note which ones.
Mark all that apply: *
Were you discharged in the past year from: *
If not, what do you need to do to get one?
If not, how do you plan to get to class on time?
Have any of the following presented difficulties at work?
Mark all that apply. And again, these are not disqualifiers.