JOB READINESS SURVEY

Please answer the questions below so that The Gateway-In Project© Placement Coordinator can best help you secure employment after your training is completed. You will be asked to upload your employment history (resume) at the bottom of this form.

CONTACT INFORMATION

First name*

Last name*

Email*

Use the email address you used when first applying for our grant.

Phone number*

Use your current phone number.

WORK REQUIREMENTS

As a participant in The Gateway-In Project© CNA & HHA grant, you agreed to meet our grant's work requirement as follows:

Work as a Certified Nursing Assistant or Certified Home Health Aide
Work in a long-term care setting with seniors for at least 12 months
Communicate with The Gateway-In Project© staff regarding your CNA State exam and your employment status

There is no requirement for how many hours you need to work (you may work full-time, part-time, or per-diem/on-call). You are allowed to work for more than one employer, as long as one of those employers meets the work requirements stated above.

Do you understand that our Placement Coordinator will help you find employment only as a CNA or HHA in long-term care for older adults?*

i.e. not a hospital, registry, behavioral health facility, pediatrics, etc.

Yes

CURRENT EMPLOYMENT STATUS

Are you currently employed?*

JOB PLACEMENT

Check this box if you would like help securing employment as a Certified Nursing Assistant or Home Health Aide. You will immediately be sent resources for finding a job, and the Placement Coordinator will reach out to you within 5 business days to assist further.

Request Job Placement Assistance

JOB SEARCH

Do you already know which facility/facilities you want to apply for?*

What type of work are you looking for?

Check all that apply.

Full-time

Part-time

On-Call

Other

What hourly pay range are you looking for?

Check all that apply.

$18-$20/hr

$21-$24/hr

$24+

Other

CERTIFICATION STATUS

It is important to keep us updated on your CNA status so that we can refer you to employment partners once certified.

Have you taken your CNA State licensing exam yet?*

RESUME SUPPORT

Do you already have a resume?*

Choose "Yes" if you have a resume, no matter how long ago it was created. The Placement Coordinator can assist with updating your information.

Yes

Please register for a mandatory post-graduation info session if you have not already done so:

Virtual Meeting Registration