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    SECTION: EMPLOYMENT INFORMATION
    * Is Participant an Incumbent Worker?
    * Receiving Unemployment Insurance Benefits?
    * Are/were you offered health benefits?
    * What is your salary currently?









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    * Training Course Selection

    Tech Frederick reserves the right to check the accuracy of the information provided. I grant permission to share my information with the Department of Labor, Licensing and Regulation (DLLR), who fund the EARN grant training program. By submitting this form, I am agreeing to complete future forms required by Tech Frederick and the MD DLLR for my participation in this free training. I understand that failure to complete forms with all required information will result in an invoice for training costs and that I will be responsible for paying this fee
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