18 years of age or older

Authorized to work in the US?

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

Do you meet any one of the following?

• 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 the member
• Receiving or have exhausted unemployment benefits and are unable to find a 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
• Receive cash (TANF) or food assistance (SNAP)
• Receive Social Security or Veterans Administration disability rated benefits
• In a household that meets low-income criteria on Poverty Guidelines

  Family Household Size	Maximum Income
  1	$51,550
  2	$60,755
  3	$83,387
  4	$102,950
  5	$121,505
  6	$142,108
  7	$162,711
  8	$183,313

• 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