please answer all questions completely
Basic Information
Are you a veteran?*
Are you eligible to work in the United States?*
What is your marital status?*
Ethnicity: Hispanic/Latino:*
Income Eligibility Verification
Which of the following best describes your employment status?*
What are your primary sources of income? (limit to two)*
Are you currently receiving food assistance?*
 Include income from spouse and anyone else that is residing with you that you are related to by blood or marriage in the following:
Do you currently have an outstanding bill at Southwestern Community College?*
Work History (Present or most recent)
Includes volunteer work, part-time/full-time and self employment.
Are you currently employed or volunteering with this employer?*
Last grade completed:*
High School Diploma or HSED completed:*
College Degree completed:*
Other training certificate or credential:*
Have you previously attempted a non-credit certificate course from SWCC but did not complete?*
Do you have a National Career Readiness Certificate?*
Are you currently a student?*
When are you available to take classes?*
Out of the following choices please pick one area that interests you the most: *
Have you considered going to college to earn a degree? *
How did you hear about GAP Tuition Assistance Program or the PACE Program?*
What would you consider are your barriers to success? *
Are you or have you been in any stage of the criminal justice process?*
Do you have any misdemeanor arrests or convictions?*
Have you been convicted of a felony?*
Are you involved in any pending legal actions?*
Are you under any court orders?*
Have you been, are you, or do you need to be involved in substance abuse treatment in order to obtain employment?*

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