1. Cultural Barriers: Because of my culture, I have different attitudes, beliefs, customs, or practices that influence my way of thinking, acting, or working. This makes it difficult for me to find employment.
2. Disabled: I have a disability. Physical or mental impairment that substantially limits one or more of a person’s major life activities as defined by ADA of 1990.:
3. Displaced Homemaker: I provide unpaid services to family members in the home and Depend on a family member for income but are no longer being supported by them, Am a spouse of an active duty (armed forces) whose income has been reduced, or Am employed/underemployed and have a hard time getting a job or getting a better job.:
4. Low Income: I receive, have received, or my family has received for 6 months (prior to application to Adult Ed) SNAP, TANF, SSI, receive state income based public assistance, or earn less than $15,630 per year (individual).:
5. English Language Learner: English is my second language. Ability to speak, read, write, or understand English is difficult.:
6. Low Literacy: It is difficult for me to compute and solve problems, read, write, or speak English needed to function on the job or in society.:
7. Ex Offender: I have been a part of a criminal justice process (any stage) for committing a status offense/delinquent act or need assistance in overcoming barriers to employment resulting from a record of arrest or conviction.:
8. Exhausting TANF Within Two Years: I have received Temporary Assistance for Needy Families (TANF) services for 3 years.:
9. Foster Care Youth: I am currently in foster care or have aged out of the foster care system.:
10. Homeless: I live in a car, park, beach, abandoned building or with family members/friends. I am without a regular place to stay at night. I am a runaway under the age of 18:
11. Long Term Unemployed: I have been unemployed for 27 or more consecutive weeks.:
12. Migrant: Low-income migrant worker and for 12 consecutive months out of 24 months prior to application employed in primarily agriculture with chronic employment or underemployment and face multiple barriers to economic self-sufficiency.:
13. Seasonal Farmworker: : Low-income seasonal farmworker and for 12 consecutive months out of 24 months prior to application employed in primarily agriculture with chronic employment or underemployment and face multiple barriers to economic self-sufficiency.:
14.Single Parent or Guardian: I am a single, separated, divorced, or widowed and have one or more dependent children under the age of 18, under my care (includes single pregnant women).:
15. Barrier: I have at least one barrier to employment listed above.:
16. AJC: Have you visited or received services from an American Job Center?
17. DLIR: Have you received workforce training from the Hawaii Department of Labor (i.e., pre-apprenticeship or apprenticeship training)?
18. DVR: Have you received career readiness or workforce preparation training from the Hawaii Division of Vocational Rehabilitation?
