English for Job Search Interest Form
Free intermediate-level English classes to learn English and basic computer skills for looking for a job in the U.S.
Thank you for your interest. Applications are not currently being accepted. If you would like to be notified when registration reopens, please fill out this interest form.
To take this class, you must:
1) Speak intermediate English
2) Want to look for a job
3) Attend all sessions
Contact Information:
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Telephone Number
*
Please enter a valid phone number.
Tell us about yourself:
*** These questions help us know you better and do not impact your eligibility.
With what gender do you identify?
*
Please Select
Male
Female
Non-Binary
I prefer to describe myself
I prefer not to answer
What is your date of birth?
*
-
Month
-
Day
Year
Where were you born?
*
Please Select
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Colombia
Congo
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
French Guinea
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Guadaloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Lithuania
Macedonia
Madagascar
Malawi
Malaysia
Mali
Martinique
Mauritania
Mauritius
Mexico
Moldova
Monaca
Mongolia
Morocco
Mozambique
Myanmar
Namibia
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
No Answer
North Korea
Norway
Oman
Other
Pakistan
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Sierra Leone
Singapore
Slovakia
Slovenia
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
St. Vincent/Grenadines
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
Virgin Islands
Western Samoa
Yemen
Yugoslavia
Zaire (Congo)
Zambia
Zimbabwe
How do you describe yourself or identify?
*
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African (MENA)
Native Hawaiian or Pacific Islander
White
Do Not Wish to Disclose
Other (please write below)
Other Race
With what origin do you closely identify?
*
Please Select
Hispanic or Latino
Non-Hispanic or non-Latino
Do Not Wish To Disclose
Tell us About Your Family and Living
When did you come to the United States?
*
-
Month
-
Day
Year
If you cannot remember mention the date with your best idea.
How many children 17-years or younger live with you?
*
Please Select
0
1
2
3
4
5
6 or more
How many other people, 18-years or older, live with you? (Do NOT count yourself)
*
Please Select
0
1
2
3
4
5
6 or more
Language and Education
What language did you speak at home when you were a child? (The language you spoke the most)
*
Please Select
AFRIKAANS
ALBANIAN
AMHARIC
ARABIC
ARMENIAN
ASSAMESE
ASSYRIAN NEO ARAMAIC
ATESO
AYMARA
AZARI
BAHASA INDONESIA
BALOCHI
BANTU
BASQUE
BENGALI
BERBER
BHOJPURI
BISLAMA (A MELANESIAN PIDGIN ENGLISH)
BOJPOORI
BOKMÅL
BRAHUI
BURUSHASKI
CASTILIAN SPANISH
CATALAN
CEBUANO
CHICHEWA
CHINESE (OTHER)
CHINESE - CANTONESE
CHINESE-MANDARIN
CHUKESE
COTOCOLI
CREOLE
CROATIAN
CZECH
DANISH
Dari
DHIVEHI
DINKA
DUTCH
ENGLISH
EWÉ
FARSI
FILIPINO (BASED ON TAGALOG)
FINNISH
FORMOSAN
FRENCH
FRENCH CREOLE
FRENCH PATOIS
FRISIAN
FULANI
GAGAUZ
GALICIAN
GERMAN
GIO
GREEK
GUARANÍ
GUJARATHI
HAKKA
HAUSA
HEBREW
HINDI
HINDKO
HIRI MOTU
HUNGARIAN
IBO
ICELANDIC
I-KIRIBATI (GILBERTESE)
ILOCANO
INDONESIAN
IRISH GAELIC
ITALIAN
JAPANESE
JAVANESE
KABYÉ
KANNADA
KAREN
KASHMIRI
KAZAK (QAZAQ)
Khmer
KINYARWANDA
KOREAN
KOSREAN
KRIO
KRU
KURDISH
KYRGYZ
LAO
LATIN
LATVIAN
LEBOA
LITHUANIAN
LUGANDA
LUO
LUXERMBOURGISH
MACEDONIAN
MAGYAR (HUNGARIAN)
MAITHALI
MALAGASY
MALAY
MALAYALAM
MALTESE
MARATHI
MARSHALLESE
MENDE
MIAO (HMONG)
MINA
MOLDOVAN
MONÉGASQUE
MONGOLIAN
MON-KHMER (CAMBODIAN)
NAURUAN
NAVAHO
NDEBELE
NEPALI
NEWAR
No Answer
NORWEGIAN
NUER
NYNORSK (FORMS OF NORWEGIAN)
ORIYA
OTHER
PALAU
PASHTU
PATOIS
PERSIAN
POHNPEIAN
POLISH
PORTUGUESE
PUNJABI
QUÉCHUA
ROHINGYA
ROMANIAN
ROMANSCH
RUSSIAN
SAMOAN
SANSKRIT
SCOTS GAELIC
SERBIAN
SERBOCROATIAN
SERER
SESELWA (A CREOLE)
SESOTHO
SETSWANA
SINDHI
SINHALA
SIRAIKI (PUNJABI VARIANT)
SLOVAK
SLOVENE
SOLOMON PIJIN (AN ENGLISH PIDGIN)
SOMALI
SONGHAI
SPANISH
SURINAMESE
Swahili
SWATI
SWAZI
SWEDISH
SYRIAC
TAGALOG
TAJIK
TAMANG
TAMIL
TELUGU
TEMNE
THAI
THARU
THE MYANMAR LANGUAGE (FORMERLY BURMESE)
TOK PISIN (MELANESIAN CREOLE ENGLISH)
TONGAN (AN AUSTRONESIAN LANGUAGE)
TSHIVENDA
TURKIC
TURKISH
TURKMEN
TUVALUAN
UKRAINIAN
URDU
UZBEK
VIETNAMESE
WELSH
Wolof
XHOSA
XITSONGA
YAPASE
YIDDISH
YORUBA
ZANDE
ZULU
What other languages do you speak?
How well do you SPEAK English?
*
Please Select
Advanced
Beginner/Basic – I can talk about simple topics or I know some words and can use short sentences
Intermediate/Conversational – I can communicate on everyday topics with small mistakes
Proficient Speaker – I understand the structure of the language and can explain how to speak to other people. I can use idiomatic language and understand local accents
Don't think about writing or reading, just SPEAKING.
What is your highest level of education?
*
Please Select
Less than a high school degree (Primary School)
High School degree or equivalent (Secondary)
GED (a certificate of secondary education)
Some College but no degree
Associate’s Degree (AA, a two-year degree)
Bachelor’s Degree (BA, BS, a four-year degree)
Master’s Degree (MA, MS, a two-year degree after your bachelor’s degree)
Post-Graduate degree (PhD, MD, the highest level degree)
Other (please write below)
Work and Income
Do you have a job right now?
*
Please Select
Self-Employed
Unemployed
Employed Part Time
Employed Full Time
How much money did you make last year?
*
Please Select
No Income
Assistance from friends or family or cash only
Under $5,000
$5,001 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $30,000
$30,001 - $50,000
$50,001 - $75,000
$75,001 and above
Please give your best idea in US dollars
If there are other people who make money in your house, how much money did everyone in your house make, including you?
*
Please Select
No Income
Assistance from friends or family or cash only
Under $5,000
$5,001 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $30,000
$30,001 - $50,000
$50,001 - $75,000
$75,001 and above
Please give your best idea in US dollars
Do you get any money or help from the government?
*
Please Select
None
Unemployment benefits
Disability SSI
Veterans Assistance
TANF
WIC
Food Stamps
I prefer not to answer
I need help with this question
How did you hear about TWC?
*
Please Select
Advertisement
Work site
Community organization
Local PA CareerLink
Court mandated
Welfare required
Other
CitySpan / My Place
Military recruiter
The Welcoming Center Website
Job Searching Website (e.g. LinkedIn, Indeed, Glassdoor)
Friend / Family / Colleague
Educational Institution / School / Class
Previously attended a program or event here
Staff from another organization
Maureen Smith
Manuel Portillo
Alaa Quniebi
Are you able to attend all sessions?
*
Please Select
Yes
No
Do you want to look for a job?
*
Please Select
Yes
No
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