Create a new account

Contact Information

Please use the XXX-XXX-XXXX format for phone numbers.

Disadvantaged Worker Assessment

Are you a veteran?
Are you homeless?
Are you a custodial single parent?
Are you receiving public assistance?
Have you received your GED or High School diploma?
Have you been unemployed for longer than 26 weeks?
If employed, have you worked less than 240 hours (30 days) in the last 180 days (6 months)?
Do you have a criminal record or other involvement with the Criminal Justice system?
Are you an emancipated foster youth?
Are you able to pass a drug test?
Are you able to pass a background check?
Are you able to lift 50 lbs. or more?

Additional Information

Are you currently receiving or have you recently received unemployment insurance (UI) benefits?
Have you been laid off from or are you going to be laid off from your job?
Do you have a valid California Driver's License?