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Workforce Development Returning Citizens Intake Form
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Middle Initial
Your answer
Last Name
*
Your answer
Street Address
*
Your answer
City, State
*
Your answer
Zip Code
*
Your answer
Phone Number
*
Your answer
Current Job Status
*
Temporary
Permanent
Full-time
Part-time
Unemployed
Long-term Unemployed (unemployed 27 weeks or more)
Required
Employer Name (current or former if unemployed)
Your answer
Employer Address
Your answer
City, State
Your answer
Job Title
Your answer
Are you an Eligible Veteran
Yes
No
Clear selection
If yes, please specify:
Your answer
Participants' Requirements for Training Program
Please check all that apply:
*
Understands that there is no guarantee of employment
Must be 18 years or older
High school diploma or GED/HSE (High School Equivalency)
Required to take the TABE Math & Reading
Must commit to attend one-hour program orientation
Must have a current conviction as an adult but never been convicted of sexual offense
Current resident in the geographic area to be served, or resident in the geographic area prior to confinement in a correctional facility, and will be returning to the geographic area to be served
Current enrollment is a state and/or local work-release program with a release date (within six months of program)
If I receive a reasonable offer from an employer after the training program, I will accept it
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This form was created inside of Greater Baltimore Urban League.
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