Surveys 2016 April U Unemployed social-needs application

Unemployed social-needs application

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Exit Survey

This form is for applying for free careers counselling under the unemployed social-needs criteria. Your application will be strictly confidential and used only for evaluating eligibility for this service. The 5 minimum criteria for an individual to apply for free careers counselling* are: 1. NZ Citizen (or Permanent Resident) who has been in involuntary unemployment for greater than 1 year 2. Average annual household income less than $20,000 per person (eg 4 people in a house who together earn $80,000 per year = $20,000 average annual household income) 3. Personal assets less than $10,000 4. Highly motivated to work 5. Considering further education If you meet these criteria please click next and complete the questions on the following page. In completing this application you are stating that the following information you give is accurate for your current circumstances.     Contact Information * First Name :  * Last Name :  * Phone :  * Email Address :        * How long have you been unemployed? -- Select --0-6 months6-12 months1-2 yearsMore than 2 years       * How long have you been actively looking for a job? -- Select --0-6 months6-12 months1-2 yearsMore than 2 years       * Are you on a NZ welfare benefit? If you have, how long have you been on the benefit?   I am not on a benefit (or I am not a NZ citizen or permenant resident)   1-6 months   6-12 months   1-2 years   More than 2 years       * How much income did all of the people in your household together earn in the last year (from all sources including all welfare benefits)? -- Select --$0 - $30,000$30,001 - $60,000$60,001 - $80,000Over $80,001     How many people live in your household including yourself? 0 1 2 3 4 5 6 7 8+ * Adults (over 18yrs old) * Children (under 18yrs old)       * Do you have more than $10,000 worth of personal assets (including car, personal devices, property, etc.)   Yes   No       * Are you considering training or studying to further your qualifications?   Yes   Maybe   No       * How motivated are you to work and what makes you to want to work rather than being on the benefit?