ONLINE PRE-ENROLLMENT FORM
This information is private and will help determine your eligibility. You will be required to meet with NAICOB Department of Employment and Training staff or Social Worker to complete your intake and be fully enrolled for our services. Should you not meet program requirements at this time, we can provide you with other resources that might help you. Our mission is to empower the Native American community with the goal of improving the quality of life of Indigenous People.
     
Advocacy Services
A licensed social worker and an attorney are available by appointment to assist with support and referral services relating to homelessness and housing, the Indian Child Welfare Act (ICWA), K-12 education and homeschooling, substance abuse, domestic violence, social services referrals, and other mental health or legal needs. Appointments are necessary. The Social Worker is available one day a week on Wednesday by appointment only please call 617-232-0343 to make an appointment.
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Email *
Name *
Location Town/State/County *
Phone Number *
Address *
Tribal Affiliation
 *
Date of Birth *
Tribal ID, CDIB, Official Enrollment Letter, Tribal Documentation -(Must be able to show Tribal Documentation or Tribal ID for Employment and Training Program eligibility and services.) *
Required
Do you have any of the following barriers to employment? (check all that apply)
Have you enrolled in the Department of Employment and Training Program before? *
Required
Employment Status *
Required
Education Status: Have you completed? *
Required
Are you currently enrolled in a school or training program? *
Required
Are you a Veteran? *
Required
Service that maybe available to you: Please check all that apply *
Required
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