18 years of age or older?

Authorized to work in the US?

Registered for selective service (males born after 1959 only; males born before 1959 and females, please select "N/A"); check registration at https://www.sss.gov?

Do you meet any one of the following:

• Receive cash (TANF) or food assistance (SNAP)
• Receive Social Security or Veterans’ Administration disability rated benefits
• In a household that meets low income criteria based on Poverty Guidelines

  Family Household Size	Maximum Income
  1	$27,556
  2	$45,154
  3	$46,481
  4	$57,384
  5	$67,727
  6	$79,209
  7	$90,692
  8	$102,174

  Family size includes those individuals that are related by blood, marriage, or decree of court, who are living in a single residence and who are:

  • A husband, wife, and dependent children
  • A parent or guardian and dependent children
  • A husband and wife
• Are Basic Skills Deficient

  What is Basic Skills Deficient?

  • Unable to speak, read, write, compute, or solve problems in English to function on the job, within the family, or in society.
• Unemployed or at a job that does not support your financial needs and are experiencing difficulty in obtaining or upgrading employment
• Are a Dislocated Worker

  What is a Dislocated Worker?

  • Dependent spouse of a military member on active duty whose income was reduced due to: deployment, permanent change of station, or service-connected death or disability of that person.
  • Receiving or have exhausted unemployment benefits and are unable to find job in your last occupation.
  • Laid off but not eligible for unemployment benefits and are unable to find a job in your last occupation.
  • Received a notice of termination from your current employer due to company closure.
  • Self-employed and now unemployed due to economic conditions or a natural disaster.
  • No longer able to depend on the income of a family member.