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Buffalo Employment and Training Center Intake Form

  1. mm/dd/yyyy

  2. Are you currently employed?*

  3. Are you currently enrolled in school?*

  4. Have you ever been convicted of a crime?*

  5. Do you currently receive unemployment benefits?*

  6. Are you disabled?*

  7. Are you on public assistance?*

  8. Are you a veteran?*

  9. How did you hear about BETC?

  10. How would you like to be informed of classes and programs at BETC and partner agencies?

  11. How would you like to be informed of closures, schedule changes and cancellations?

  12. Leave This Blank:

  13. This field is not part of the form submission.