STEAMe

Learner Intake & Interest Form

This form helps us understand your goals and see whether they align with the AK Public Pathways program. Information you provide will help us connect you to relevant training or job opportunities and identify any support that could help you participate. You can complete this form whether you’re employed or not, and there are no right or wrong answers. All training and support are subject to program guidelines, approval, funding availability, and federal requirements. Your information is used only for program administration and required reporting.

Legal First Name *

We use this to identify you in the program and for required reporting.

Legal Last Name *

We use this to identify you in the program and for required reporting.

Email *

We’ll use this to share updates, training information, and opportunities related to AK Public Pathways.

Phone Number *

A cell phone number is preferred so we can follow up or offer support if needed.

Opt in to receive text notifications and AI-powered check-ins from STEAMe? *

Opt out anytime. Message and data rates apply.

Zip Code *

The zip code helps us understand where participants are located and report on how the program serves communities across Alaska.

Race *

This information helps us understand eligibility for certain program supports and meet required federal reporting.

Birth Date *

This is used only for required program reporting and to understand who the program serves. It is not used to limit participation.

Current Employment Type *

Current Employer *

This helps us understand your current employment situation. If you are not currently employed, enter “Not employed.”

Current Job Title or Role *

This helps us understand your starting point and track career progress. If you are not currently employed, enter “Not employed.”

Current wage (USD) *

This helps establish a baseline for tracking program outcomes. Please enter your hourly wage (for example, “$40/hour). If not employed, you may enter “$0/hour."

Industries of Interest *

Select the industries you are most interested in right now. This helps us confirm that your career goals align with AK Public Pathways.

Desired Career Outcome *

Choose the option that best matches your main goal.

Training Interest Areas *

This helps us understand the types of skills or training areas you’re interested in and identify options that may be supported through the program.

Support Requests *

We ask about support needs to understand barriers to participation and explore options that may help you access training or employment. All participants have access to the AK Public Pathways job portal. Any additional support is subject to program guidelines, approval, and availability, and not all requests can be approved.

Training Format or Credential Type *

This helps us understand the level, format, and type of training you’re looking for so we can explore options that fit your goals. Training and support are subject to program guidelines, approval, funding, and availability.

Occupation interests

Select any of the following jobs or roles you are interested in, working toward, or currently performing. Job titles can vary by community, and in Alaska it’s common for people to wear multiple hats. For example, a city or tribal administrator may also handle emergency management. Choose the options that best fit your interest.

Specific Training Program or Provider

If you already have a specific training program, school, or provider in mind, please share it here to help us explore alignment and next steps more quickly.

Additional Information

Please use this space to explain any “Other” selections or share anything else you would like us to know.

By typing a name below, the learner (or an authorized representative, if applicable) confirms that the information in this form is true to the best of their knowledge. If eligible, the learner agrees to participate in this program and understands that program staff may contact them for up to six (6) months after completing the program to check on progress or employment. The learner also agrees that their information may be collected, used, and reported as required for this program, including reporting to the U.S. Economic Development Administration (EDA). *

Type your first and last name, or if someone helped complete this form, their name and relationship (for example: “Jane Smith, trainer”).