Job Fair Registration
Job fair at City of Refuge 1300 Joseph E Boone Blvd
Email
First Name
Last Name
Phone Number
Birthdate
Primary Street
Primary City
Primary State/Province
2 digit state code
Primary Zip/Postal Code
5 digit zip code
County
Please select...
Barrow
Bartow
Butts
Carroll
Cherokee
Clayton
Cobb
Coweta
Dawson
DeKalb
Douglas
Fayette
Forsyth
Fulton
Gwinnett
Haralson
Heard
Henry
Jasper
Lamar
Meriweather
Morgan
Newton
Paulding
Pickens
Pike
Rockdale
Spalding
Walton
Other
Program
AARP Back to Work 50+
Culinary
Coding
Cybersecurity
Forklift Training
GED
Inspired By Arby's
Logistics
Launch
NAPA Automotive Technician
Pour Over Love
Security Guard
Job Placement
Ethnicity
Please select...
Hispanic or Latino
Non-Hispanic or Latino
Race (please check all that apply)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
US Citizen
Please select...
Yes
No
Highest Level of Education
GED or Diploma
Some High School
Some College
College Degree
Have you served in the US Military?
Please select...
Yes
No
Are You Disabled
Yes
No
Do you receive Public Benefits
Yes
No
Do you or a member of your household have Medicaid?
Yes
No
Who is the Medicaid provider?
Please select...
Amerigroup Community Care
CareSource Georgia
Peach State Health Plan
WellCare of Georgia
Other
Have you been convicted of a felony
Yes
No
Gender
Please select...
Male
Female
Did not self-identify
Current Employer
Current Hourly Wage
Service Schedule ID
Service Session Name
Start Date and Time
Contact Information