CSPBC Apps

CSPBC Short Form

Event :

Paychecks for Patriots 2025 at Hilton Majestic Ballroom 150 Australian Ave. West Palm Beach, FL 33406 on 11/5/25 starting 9:00 AM to 1:00 PM

How did you hear about this job fair? *

Enter your email address *

Do you require any ADA accommodations? *

Yes

Please fill out this form to be registered in Employ Florida and to be registered for this Job Fair

First Name *

Middle Name

Last Name *

Current Address *

City *

State *

Zip *

Phone *

Date of Birth *

SSN (Please include dashes) *

Receiving unemployment insurance?

Desired job? *

Highest level of education?

Last grade completed?

Please select your race from the list *

Are you of Hispanic or Latin Heritage?

Gender? *

Are you a US citizen? *

Do you have a disability? *

Have you worked as a Migrant Seasonal Farm Worker within the last 12 months? *

Yes

This information will be used to create or update an account on EmployFlorida.com and for referrals to be made to qualified job openings. I acknowledge recruiters may contact me regarding job opportunities and agree with Terms of Use of Employ Florida *

Signature(Enter your full name) *

Date

* The information is voluntary and will be kept confidential under Federal Law requirements of individuals seeking services through the American Job Centers. The refusal to provide the information will not subject the individual to any adverse treatment. The information provided will only be used in accordance with the law.

Please be advised that CareerSource Palm Beach County (CSPBC) may capture photographs, audio, and video during this event. These recordings may be used by CSPBC for promotional, informational, or educational purposes, including use in publications, websites, social media, and other communications channels.