Farmworker Form

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Farmworker Service Interest Form

Hello! Please tell us about yourself in the form below to start your educational journey. For help with this form, please call 559-471-4550

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First Name (primer nombre)

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Phone number (N煤mero de tel茅fono):

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email address (direcci贸n de correo electr贸nico)

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What is the best time to call? (驴Cu谩l es el mejor momento para llamar?)

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City

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聽In partnership with the National Farmworker Jobs Program (NFJP), 好色先生 offers employment services that prepare eligible farmworkers for new jobs. Our representatives will work with you to develop an individual plan to meet your career needs.聽

Select your nearest Service Center Office (Seleccione la oficina de 好色先生 m谩s cercana a usted):

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Which programs are you interested in (Select all that apply)

Career counseling (Orientaci贸n profesional)

Job placement assistance (Asistencia para la colocaci贸n de empleo)

English as a Second Language (Ingl茅s como segundo idioma)

Office Occupational Skills (Habilidades ocupacionales de oficina)

Truck Driver (Conductor de cami贸n)

Medical Assistant (Asistente m茅dico)

Forklift (Montacargas)

Dental Assistant (Ayudante de dentista)

Certified Nursing Assistant (Asistente de Enfermer铆a)

Basic Computer Training (Capacitaci贸n de computadora basica)

Food Assistance (Asistencia alimentaria)

Rent Assistance (Asistencia de alquiler)

Utility Assistance (Asistencia de servicios p煤blicos)

Remedial Education GED Preparation (Preparaci贸n para el GED)

Youth Programs (Programas Juveniles)

Financial literacy (Educaci贸n financiera)

Other (Otro):

Rapid Response (Fresno, Kings, Tulare Counties):

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How many years have you been a farmworker? (Por cuantos a帽os has sido trabajador(a) agr铆cola?)

1-2

3-5

6-10

11-15

16-20

21-25

26-30

31-35

40+

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What type of farm labor have you worked in? (驴Qu茅 tipo de trabajo agr铆cola hace usted?)

Dairy Products, Milk

Grapes-table

Raisins

Wine

Almonds

Peaches

Garlic

Cattle and Calves

Strawberries

Blueberries

Pistachios

Lettuce

Tomatoes

Walnuts

Rice

Citrus

Hay

Alfalfa

Cotton

Asparagus

Other

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captcha(*)

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