Moving Careers Forward – Michigan Works! Southeast

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Moving Careers Forward

First Name(Required)

Last Name(Required)

Email Address(Required)

County of Residence(Required)

Phone(Required)

Are you a Veteran(Required)

Yes

No

I am an eligible spouse of a veteran

Do you have a High School Diploma or GED®?(Required)

I have a high school diploma

I have a GED®

I do not have a high school diploma or GED® and I am interested in completing my education

I do not have a high school diploma or GED® and I am not interested in completing my education

Are you Currently a Student at Siena Heights University(Required)

Yes

No

Program of Interest(Required)

Are you currently employed?(Required)

Yes

No

Are you between the ages of 18-24?(Required)

Yes

No

Who referred you to this form(Required)

Siena Heights University Staff

Michigan Works! Southeast Team Member

Other

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Connecting the Counties of Hillsdale, Jackson, Lenawee, Livingston, and Washtenaw

Michigan Works! Southeast is an Equal Opportunity Employer/Program| Auxiliary aids and other accommodations are available upon request to individuals with disabilities | Supported by the State of Michigan | Paid for with State / Federal Funds |Proud Partner of the American Job Center Network | Toll-free telephone number 1-800-285-WORK (9675)| TTY: 7-1-1

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