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Please enter your FIRST NAME. *

Please enter your LAST NAME. *

Please enter your birth date. *//

Please choose your age group. *

*Students under 18 years old may be required to provide additional information in order to be eligible to attend classes at OIC.

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Please select the language you use at home (optional)

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DIRECT CARE WORKER TRAINING COURSE

OIC is offering a one-day Direct Care Training course on Wednesday, October 26, 2021. (Location to be determined). The class will be held from 9 am until 2:30 pm. Would you like to take the course? (Check Yes or No.)

Yes, I would like to take the Direct Care Worker training course.
No, I am not interested.

ESL (English as a Second Language) Classes

Yes

Are you an Afghan Refugee?

Yes

GED or HiSET Diploma Classes (Face-to-Face and Remote)

Yes

Digital Literacy (Basic Computer Skills, Internet Basics, Microsoft Word, Using Emails, and Windows Basics)

Yes

Financial Literacy ( Counseling for Budgeting, Personal Finance, Renting and Home Buying)

Yes

How Many People Live In Your House? *

What is your total household income. *

These classes are also available NOW. Check the class(es)/courses that you would like to take.

Culinary Training (for ESL Students)
Road to Success (Help Finding a Job with Local Partner Employers)
SOAR - Reentry Support Services (Vocational Skills Training, Support Services, and Job Placement for Justice Involved 18-24 year olds.
Workforce Readiness (Counseling, Education and Training, for Career Pathway Exploration)

You may choose more than one.

These classes are NOT offered now. Select if you want to be notified when the class(es)/course is offered) (Check the OIC class(es)/courses that you would like to take.

Direct Care Worker (Home Health Aide)

You may choose more than one.

If you checked more than one course please check below the course that is the most important to you at this time.

ESL (English as a Second Language) Classes
GED or HiSET Diploma Classes (Face-to-Face and Remote)
Financial Literacy (Counseling for Budgeting, Personal Finance, Renting and Home Buying)
Culinary Training (for ESL Students)
Road to Success (Help Finding a Job with Local Partner Employers)
SOAR - Reentry Support Services (Vocational Skills Training, Support Services, and Job Placement for Justice Involved 18-24 year olds.

Choose only one.

Please check any barriers you may have that would keep you from coming to class. *

Please use the box below to explain more about any barriers you might have.

Check all the times that you are able to attend classes. *

Please answer each of the above questions. *

	Yes	No	Maybe	I'm not sure
Can you attend face-to-face classes at school?	Can you attend face-to-face classes at school? Yes	Can you attend face-to-face classes at school? No	Can you attend face-to-face classes at school? Maybe	Can you attend face-to-face classes at school? I'm not sure
Can you participate in remote classes?	Can you participate in remote classes? Yes	Can you participate in remote classes? No	Can you participate in remote classes? Maybe	Can you participate in remote classes? I'm not sure

Do you have Internet access? *

Please answer "Yes" or "No" to the question above.

Please check your reason(s) for returning to school. *

You can check more than one reason.

Other

Please indicate your current work status. *

Please estimate your income over the last 12 months. *

SNAP Recipient - Are you receiving SNAP benefits? *

TANF Recipient - Are you receiving TANF cash benefits? *

Are you interested in taking Nurse Aide (CNA) classes? *

Are you interested in taking Culinary (Cooking) classes? *

Are you interested in taking Welding classes? *

How did you learn about OIC? (Optional)

Please complete this sentence. "After I finish my classes at OIC, my goal is to ...."

Have you attended OIC before? *

Yes, I have been a student before.
No, I have never attended OIC before.

Photo Release *

Yes
No

Photo release: "I give my permission and consent to be photographed during OIC activities. I further give permission and consent for OIC to publish and use such photographs to illustrate and promote the OIC experience and programs."

Check "Yes" ONLY if you live in the Uptown Section of Harrisburg?

Yes, I live in Uptown Harrisburg.

Answer this question ONLY if you live in UPTOWN Harrisburg. Of the below options, which three would you most like to see added to the Uptown community? You can select three choices. *

Other

Please list any other services you would like to see in the uptown community.

Additional Information

Please add any additional information that would help us provide you with the educational and training help you need.

CALL US: (717) 238-7318

Complete this form to register online. NOTE: To send your registration form, you must click the SUBMIT button at the bottom of this page.

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