Registration Form

On behalf of the Job Fair Planning Team, thank you for your interest in pursuing employment in southern Virginia.  The information you provide is considered confidential and will only be shared with members of the planning team.  Information will NOT be shared with employers. Use CAPITAL letters and use an "X" in marking choices.
NAME:
 
 
Address:
 
 
  
  
Please indicate the location the phone number is for.
 
 
What is the highest grade of school you have completed, or the highest degree you have received (check only one box)?
 
 
 
 
 
Have you taken the WorkKeys or National Career Readiness Certificate (NCRC) assessment?
 If yes, select level earned:
 
Please select all that apply to you:
 
 
 
Are you registered with the Virginia Workforce Connection?
 
      If not registered, would you like to be?
 
If currently enrolled as a student, please list the school/college:
 
If NOT enrolled, would you be willing to go to school/college to receive training for a job opportunity or promotion?
 
  Page 1/1  
Snap Survey Software