Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Gateway Academy Screener

  1. Gateway Academy Services Request

  2. please enter the mm/dd/yyyy for your date of birth.

  3. Are you currently a Norfolk resident? *

  4. Are you currently receiving SNAP or Medicaid benefits?*

  5. Are you currently receiving TANF benefits?*

  6. Was your employment impacted by the COVID-19 pandemic?*

  7. If you answered Yes, to the above question, please check one of the below on how you were impacted by COVID-19*

    Enter N/A if you answered No to being impacted by the COVID-19 pandemic.

  8. Have you ever been convicted of a misdemeanor or felony charge*

  9. Are you between the age of 18-49 years old with no dependents on your SNAP case? Please answer N/A if you do not have SNAP benefits.

  10. Are you a youth or young adult (age 17-27) who is transitioning out of foster care?

  11. Do you have a child support case with TANF debt owed?

  12. Which training program are you interested in?

  13. Leave This Blank:

  14. This field is not part of the form submission.