Eligibility Form
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PROGRAM ELIGIBILITY APPLICATION
PLEASE NOTE -- At this time, we are only able to accept applications from residents in the 7 county metro area: Anoka, Carver, Dakota, Hennepin, Ramsey, Scott and Washington counties in Minnesota.
Previous Application
If you previously applied in 2020 or later, do
NOT
submit this form. Instead, reach out to us at outreachteam@twincitiesrise.org to complete your enrollment!
Have you applied to Twin Cities Rise before 2020?
Please select...
Yes
No
At what location
did you previously apply?
What
year
did you previously apply?
Contact Information
First Name
Middle Name
Last Name
Preferred pronouns
Please select...
she/her/hers
he/him/his
they/them/theirs
ze/zir/zirs
Mobile Phone
Sign up for SMS Alerts
By checking the box, you agree to receive text messages from Twin Cities Rise. Message and data rates may apply. Message frequency varies. Reply HELP for help and STOP to cancel.
Twin Cities Rise Privacy Policy
Landline Phone
Preferred Phone Number
Please select...
Mobile
Landline
Email
Date of Birth (Date must be MM/DD/YYYY format)
Address of Residence
Street Address
Enter in your street address, as well as apartment or unit number. Example "123 Main St - Apt 2C"
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Postal Code
What County do you live in?
Please select...
Hennepin
Ramsey
Anoka
Carver
Dakota
Scott
Washington
Don't Know
Other
Mailing Address
- If different from above residence address
Address
Example "123 Main Street, Apt 2C"
x
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Postal Code
Emergency Contact Person
This is someone who can get a message to you if we cannot reach you.
Emergency Contact First and Last Name
Emergency Contact Phone
Relationship
Relative, Spouse, Friend, etc.
x
Program Information
How did you hear about Twin Cities R!SE?
Please select...
Current Twin Cities R!SE Participant
Twin Cities R!SE Graduate
Twin Cities R!SE Staff
NAZ
Facebook
Instagram
YouTube & TV
LinkedIn
Agency/Community Orginization
Family/Friend
Twin Cities R!SE e-newsletter
Online/Google
Job /Resource Fair
Minneapolis Public Housing
Walked In
Correctional Facility
Treatment Program
CareerForce
Please enter the name of the person or organization that referred you to TCR if applicable
Name of TCR Outreach Team
Please select...
Quinten Osgood
Leila Hussain
Anthony Richmond
Sebrum Herron
What program are you applying for?
Please select...
My Road to Success (Individual Career Path)
Facilities and Maintenance
Customer Support
What career fields are you interested in?
Please select...
Administration/Office Operations
Building Operations/Maintenance
Don’t Know
General Customer Service Work
Health Care Worker
Hospitality and Food Service
Human Services Professional/Public Service
Manufacturing and Production
Non-Profit Work
Use Ctrl or Cmd to select multiple options.
What technology do you have access to?
Please select...
Laptop
Desktop
Phone
Tablet
Other
Verification of Eligibility
Our programs are available to participants of a variety of backgrounds. However, a few conditions need to be met in order to be eligible.
Please indicate whether the following statements apply to you:
I am 18 years or older.
Please select...
Yes
No
Does your household (you and tax dependents) meet the following income guidelines for the past 12 months?
Please select...
Yes
No
You will be asked after enrollment to provide income tax forms (or other statements) to document your income for the last year.
I am committed to pursuing full-time employment(minimum 32 hours/week) and am fully available to participate in training that supports this goal.
Please select...
Yes
No
I am
eligible to be legally employed
in the United States now and for the next two years.
Please select...
Yes
No
You will be asked after enrollment to provide documents proving your eligibility to work.
I am fully committed to attending and actively participating in the entire training program.
Please select...
Yes
No
Candidates who have been convicted of a criminal sexual conduct or arson crime are not eligible for the TCR training program.
Please indicate whether the following statement applies to you.
I have been convicted of a Sexual Offense or Arson crime.
Please select...
Yes
No
Attending an information session is required for admittance into our training programs.
I will attend an info session, if invited
Upon submission, you can no longer change this form. All information will be sent to Twin Cities R!SE for review.
Information contained on this pre-application will be used for determining eligibility for program admissions and marketing for other program services and will be kept confidential.
HIDDEN QUESTION retain for post covid life offering specific sessions. Once a schedule for info sessions is created. Create them in SF, add dates/times here as values. Then in Connector. Add Campaigns ID to create Campaign Members.
Attending an information session is required for admittance into our training programs. Please select which session you would like to attend.
Please select...
May 15 10-12
May 30 1-3
Choice C
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