Dislocated Worker and Minneapolis Works Eligibility Form

First Name *

*

Middle Name *

*

Last Name *

*

Address

Primary Phone Number *

*

Secondary Phone Number

Email Address *

*

Confirm Email Address *

*

Are you older than 18? *

Yes

No

How can we help?

Are you receiving unemployment insurance?

Yes

No

553 Fairview Ave. N
St. Paul, MN 55104
651-379-5800

Goodwill-Easter Seals Minnesota is a 501(c)(3) non-profit organization that envisions a world where everyone experiences the power of work.

A proud partner of the American Job Center network. Goodwill-Easter Seals Minnesota is a tax exempt organization. Tax Exempt#: 8357182.