Employment Readiness Assessment Form Web Site First Nation: * Interviewee Name: * Youth Interviewed Information (Anonymous) Gender: * Male Female Other Prefer not to specify Age: * 15-18 19-24 25-30 31-35 Notes for using this Assessment Tool 1. Y or N must be entered 2. Scores and totals are calculated automatically TRANSPORTATION Do you have a valid Driver's License? * Y N Have you ever had a valid Driver's License? * Y N Have you ever had your Driver's License revoked? * Y N If yes, which of the following apply? ICBC Debt ICBC Fines Family Maintenance Enforcement FMEP Impaired or other Criminal Charge I have insurance for my vehicle * Y N I have reliable transportation to/from work or job search * Y N I have reliable transportation in order to participate in a job search or employment program * Y N CHILDREN I have children (if no, skip to HOUSING. If yes, Continue on CHILDREN * Y N I have children in the home to support on a full-time basis * Y N I share custody of my children and have them part-time * Y N My child/ren are in care of the Ministry or family member * Y N I have childcare for employment, training and/or job search * Y N If no, I can obtain childcare * Y N HOUSING I have enough income to live on and pay rent/utilities, etc. * Y N I am behind in my rent/mortgage * Y N My current living situation is secure * Y N I am about to be evicted and/or have hydro cut off * Y N Are you responsible for your own housing * Y N I am in an overcrowded home (do not have my own bedroom). * Y N FINANCIAL I have been on income assistance 6 out of the last 12 months * Y N I have been on income assistance for more than 1 year * Y N I have been on income assistance for more than 2 years * Y N My parents were/are on income assistance * Y N My credit history is good * Y N I am currently involved with bankruptcy or have claimed bankruptcy in the past * Y N I have a child support order * Y N I am having a difficult time making child support payments * Y N I am involved with the Family Maintenance Enforcement Program * Y N I am stressed about money and could benefit from credit counseling * Y N RESIDENTIAL SCHOOL Do you identify as a Residential School Survivor? * Y N Are you a Second Generation Survivor (your parent/s attended IRS)? * Y N Are you a Third Generation Survivor (your grandparent/s attended IRS)? * Y N LEGAL I have a criminal record with one or more convictions * Y N My charges are related to drug and/or alcohol use * Y N I have one or more charges pending * Y N I am currently on probation * Y N HEALTH I have physical health issues that may limit or prevent employment * Y N I am concerned about my physical fitness, weight and/or my appearance * Y N I have mental health issues that may limit or prevent employment * Y N I have immediate family members who have serious health issues * Y N I struggle with depression, low self-esteem, lack of energy or motivation * Y N I have a history of drug and/or alcohol abuse * Y N I grew up in a home with drug and/or alcohol abuse * Y N Family violence is present in my household * Y N Family violence includes emotional, spiritual, physical or sexual abuse I have learning challenges * Y N If yes, please select all the apply ADD ADHD Dyslexia Asperger's Other I have applied for a Disability Pension or benefits * Y N EDUCATION AND SKILLS I have my Grade 12 Dogwood or GED * Y N I have some Post Secondary education * Y N I have completed Essential Skills training * Y N I have basic reading and/or math skills * Y N I have some beneficial work experience * Y N I feel I have marketable job skills * Y N I have some certificates/licenses * Y N I have some difficulty with reading and writing * Y N I have been fired from a job * Y N If yes, the firing was related to alcohol and/or drug use * Y N I have been laid off from my job in the last 12 months * Y N I have applied for unemployment benefits * Y N I am eligible for unemployment benefits * Y N I have applied for CERB * Y N I am eligible for CERB benefits * Y N EMPLOYMENT I have knowledge about careers that are available and currently in demand * Y N I have completed a career assessment within the last 12 months * Y N I need help listing my personal strengths and weaknesses and discussing my career goals * Y N eg. strengths; self starter, care about safety, team player - weaknesses; history of conflicts at work, trouble asking for help, easily distracted I have completed an employment program in the last 12 months * Y N If yes, what was the Program Name: I know how to find and apply for a job that meets my needs * Y N I have a current resume that I can use to get a job * Y N I have the necessary computer skills to find and apply for jobs on the Internet * Y N I am comfortable completing job applications online with attachments * Y N I could use some help with my interviewing skills * Y N I feel I am ready and prepared to work full-time * Y N I feel I am ready and prepared to work part-time * Y N I do not feel ready or prepared to work * Y N What do you believe to be your top three barriers to employment? * What do you believe to be your top three barriers to employment? * What do you believe to be your top three barriers to employment? * Please indicate any other barriers that were not mentioned in this assessment Please use this space to include any additional comments you feel may be helpful.