This is a five-part question. Please read carefully. If you can answer yes to ANY of the following FIVE questions, please answer YES in the box below:
a) Have you received conditional certification for the Work Opportunity Tax Credit and do you have a Federal Form 9062 "Conditional Certification Form" from a State Employment Agency or Job Corp Office? OR
b) Were you referred to this position after or while receiving rehabilitation services under a state plan of employment or a program approved through the Department of Veterans Affairs? OR
c) Have you received Supplemental Security Income (SSI) benefits for any months in the last 60 days? OR
d) Are you in receipt of a "Ticket to Work?" OR
e) Are you a disabled veteran of the U.S. military and have been either unemployed any 6 of the last 18 months or released or discharged from active duty in the last year?