WIOA Online Application

WIOA Pre-Application

If you have any questions while completing this pre-application, please call (217) 342-2193 ext. 2112.

NOTE: Backing out of this form before clicking the submit button at the bottom will clear all of the fields that have been filled in.

Filling out this pre-application does NOT guarantee acceptance into the CEFS WIOA Program.

First name

Last name

Gender

Male

Female

Undeclared

Address

Country/Region

Address

City

Zip / Postal code

Phone

By providing a telephone number and submitting this form, you are consenting to be contracted by SMS text message. Message & data rates may apply. You can reply STOP to opt-out of further messaging.

Email

County of Residence

Do you or any household member receive:

SSI

TANF

Food Stamps

None of these

Do any of the following apply to you?

Person with disabilities

Pregnant

Parent

Runaway

Foster child or aged out of foster care

Subject to justice system

Low income and needing assistance with low math or reading skills

Low income and needing assistance to complete an educational program or secure and hold employment

None of these apply

Have you filled out FAFSA?

Yes

No

C.E.F.S. Economic Opportunity Corporation

1805 South Banker Street

Effingham IL 62401

217.342.2193

WIOA Pre-Application

If you have any questions while completing this pre-application, please call (217) 342-2193 ext. 2112.