WDI Participant Profile
Full Name
*
First Name
Last Name
Date of Birth:
*
/
Month
/
Day
Year
Date
Age:
*
Sex:
*
Please Select
Male
Female
Last 4 of SSN:
*
Race:
*
Please Select
White
African-American
American Indian/Alaska Native
Asian
Native Hawaiian/Other Pacific Islander
Other
Ethnicity:
*
Please Select
Not Hispanic or Latino
Hispanic or Latino
Housing Resident?
*
Please Select
YES
NO
Are you currently employed?
*
Please Select
YES
NO
If Yes, Employer's Name:
If Unemployed, how long since your last job?
Highest Education Level:
*
Please Select
Some High School
HS Diploma/GED
Certificate
Some College
Associates Degree
Bachelor Degree
Master Degree
Doctorates Degree
Certificate for:
Associate's in:
Bachelor's in:
Master's in:
Doctorate's in:
Computer Skills:
*
Never
Sometimes
All the Time
I have an email address and communicate with email:
I use Microsoft Word:
I search the Internet:
I use Facebook or other Social Media:
What are other computer programs you are comfortable using?
*
What is your dream job?
*
How did you hear about the Workforce Development Institute?
*
Select One
Internet
Word of Mouth
WDI Instructor
Newspaper
Facebook
Twitter
Other
In what areas do you feel you need the most improvement?
*
Postive Attitude
Attendance
Adaptability
Responsibility
Problem-Solving
Team Work
Professionalism
Communication
ALL OF THE ABOVE
Other
Why did you join W.D.I.?
*
What do you expect from W.D.I.?
*
Pant Size:
*
Please Select
28x28
28x29
28x30
28x31
28x32
28x33
28x34
29x28
29x29
29x30
29x31
29x32
29x33
29x34
30x28
30x29
30x30
30x31
30x32
30x33
30x34
31x28
31x29
31x30
31x31
31x32
31x33
31x34
32x28
32x29
32x30
32x31
32x32
32x33
32x34
33x28
33x29
33x30
33x31
33x32
33x33
33x34
34x28
34x29
34x30
34x31
34x32
34x33
34x34
36x28
36x29
36x30
36x31
36x32
36x33
36x34
38x28
38x29
38x30
38x31
38x32
38x33
38x34
40x28
40x29
40x30
40x31
40x32
40x33
40x34
42x28
42x29
42x30
42x31
42x32
42x33
42x34
44x28
44x29
44x30
44x31
44x32
44x33
44x34
46x28
46x29
46x30
46x31
46x32
46x33
46x34
48x28
48x29
48x30
48x31
48x32
48x33
48x34
50x28
50x29
50x30
50x31
50x32
50x33
50x34
Neck Size:
*
Please Select
14
14.5
15
15.5
16
16.5
17
17.5
18
18.5
19
19.5
20
20.5
21
Shirt Size:
*
Please Select
Small
Medium
Large
Extra Large
1XL
2XL
3XL
4XL
5XL
Length:
*
Please Select
30/31
32/33
34/35
36/37
Type of Fit:
*
Please Select
Petite
Tall
Juniors
Plus
Pant Size:
*
Please Select
0
1
2
3
4
5
6
7
8
9
10
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Shoe Size:
*
Please Select
5
5.5
6
6.5
7
7.5
8
8.5
9
9.5
10
10.5
11
11.5
12
12.5
13
13.5
14
14.5
CLASS NUMBER:
Submit
Print Form
Should be Empty: