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Full Registration Form
Login Information
First Name
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Last Name
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Middle Initial
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Last 4 of Social Security number
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Zip Code
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Phone Number
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Email Address
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Are you between 16-24 years old?
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Yes
No
Are you a veteran or veteran's spouse/caregiver?
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Yes
No
How did you hear about this event?
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Flyer
Email
Facebook
Instagram
News
Radio
TV
www.wccnm.org website
Word of Mouth
Other (please specify)
Other (please specify)
Your highest education level achieved
*
Did not receive High School Diploma
High School Diploma
Vocational school certificate
General equivalency degree (GED)
Years of college/Technical/Vocational School
Associate degree
Bachelor's degree
Master's degree
Doctorate degree
Specialized degree (e.g. MD, DDS)
Current needs:
Job placement assistance
Education
Resources
Internships
I authorize the NM Workforce Connection to create an account in the www.jobs.state.nm system on my behalf if I do not have an existing account. The NM Workforce Connection will provide account information via the email address provided.
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Yes
No
Completion
Signature
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