First Name: *
Last Name: *
Email Address: *
Confirm Email: *
County: *	Please Select Columbia County Greene County
City: *
State: *	NY
Zip: *
Counselor Name: *	Please Select None Beeble, Katie Kowalski, Bernadette Lombardo, Debra Wanek, Holly
Veteran Status:	Please Select Non-Veteran Served less than 180 days Served more than 180 days Eligible Spouse
Race/Ethnicity:	Please Select Hispanic/Latino American Indian/Native Asian Black/African American Native Hawaiian/Pacific Islander White Decline to Answer
Disability Status:	Please Select Yes No Decline to Answer
Gender:	Please Select Male Female Declined to answer
Date of Birth: *	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915
What are you interested in?:	Accountant Administrative Assistant Administrative Professional Ambulance Driver/Attendant Amusement and Recreation Attendant Assessor Athletic Trainer Audio and Video Equipment Technician Audiologist Auditor Baggage Porters and Bellhops Bartender Business Analyst Buyer Carpenter Cashier Chief Executive Child Care Worker Claims Examiners, Property and Casualty Insurance Clerk/Associate Clinical, Counseling, and School Psychologist Cloud Administrator Cloud Engineer Compliance Officer/Specialist Computer and Information Systems Manager Computer Numerically Controlled Machine Tool Programmer, Metal and Plastic Computer-Controlled Machine Tool Operator, Metal and Plastic Concierge Construction Laborer Construction Manager Control System Engineer Cook/ Chef Copywriter/ Editor Credit Analyst Customer Service Representative Data Architect Data Entry Specialist Database/Server Administrator Demonstrator/Product Promotor Developer/Programmer Electrician Emergency Medical Technician (EMT) and Paramedic Employment Specialist Español Financial Analyst Financial Manager Fitness Trainer/Aerobics Instructor Flight Attendant Food Server Food Service Manager Freight, Stock, and Material Mover Front Desk Clerk Fundraiser General General and Operations Managers General Laborer Grant Writer Graphics Designer Health Specialties Teacher, Postsecondary Heating, Air Conditioning, and Refrigeration Mechanic Heavy Equipment Operator Home Health Aide Host/Hostess Human Resources Administrator Human Resources Manager Industrial Machinery Mechanic Industrial Truck and Tractor Operator Industrial-Organizational Psychologist Information Scientist Insulation Worker Insurance Adjusters, Examiners, and Investigators Insurance Appraisers, Auto Damage Insurance Sales Agent Insurance Underwriter Interpreter/Translator Janitors and Cleaners Landscaping and Groundskeeping Worker Legislative Liaison Licensed Practical/Vocational Nurse (LPN/LVN) Lifeguard, Ski Patrol, and Other Recreational Protective Service Worker Loan Counselor Loan Officer Lodging/Hotel Manager Logistician Logistics Analyst Logistics Manager Machine Operator Maintenance and Repair Worker Manicurist/Pedicurist Market Researcher Marketing Director Marketing Manager Marriage and Family Therapist Mechanic/Technician Medical and Clinical Laboratory Technician Medical and Health Services Manager Medical Assistant Medical Imaging Medical Records/Coding Medical Secretary Meeting, Convention, and Event Planner Mental Health Counselor Mobile App Developer Municipal Clerk Network Administrator Network Design Engineer Network Specialist Nursing Aides, Orderlies, and Attendants (CNA) Nursing Instructor and Teacher, Postsecondary Office Manager Operations Manager Operations Research Analyst Parks/Recreation Director Patient Care Technician Personal Care Aide Personal Financial Advisor Pharmacist Pharmacy Technician Physical Therapist Physical Therapist Aide/Assistant Physician Assistant (PA) Physicians and Surgeons Pilot Policy/Budget Analyst Policy/Budget Writer Production Supervisor Production Worker Program Administrator Program Manager Project Coordinator Project Manager Psychologist Psychotherapist Public Relations Manager Public Relations Specialist Purchasing Manager Recreation Worker Recruiter Registered Nurse Rehabilitation Counselor Retail Salesperson Sales Associate Sales Manager Secretary/Office Assistant Security Professional Separating, Filtering, Clarifying, Precipitating, and Still Machine Setter, Operator, and Tender Service/Help Desk Skincare Specialist Social and Human Service Assistant Social Media Consultant Social Worker Sonographer/Ultrasound Technician State/Federal Agency Director Substance Abuse Specialist Supply Chain Manager Systems Analyst Systems Engineer Taxi Drivers and Chauffeurs Team Assembler Teller Tour Guide/Escort Training and Development Manager Training Manager Transportation Security Screeners Travel Guide Truck Driver Urban/Regional Planner Ushers, Lobby Attendants, and Ticket Takers Voice Engineer Voice Technologies Administrator Warehouse Manager Web Designer Welders, Cutters, Solderers, and Braziers Youth
Employment Status: *	Not Provided Employed Employed - Part Time Unemployed - Receiving Unemployment Compensation Unemployed - NOT Receiving Unemployment Compensation
Education: *	Some Highschool Highschool Graduate GED Some College Post-Secondary Certificate Associate's Degree Bachelor's Degree Post-Baccalaureate Certificate Master's Degree Post-Master's Certificate Doctoral Degree Post-Doctoral Training
Preferred Language:	English Español (Spanish) 中文 (Chinese)
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