Apply for Job Training

Full Name

First NameLast Name

Phone Number

Area CodePhone Number

E-mail

Full Name*

First NameLast Name

Gender:*

MaleFemale

Phone Number*

Area CodePhone Number

E-mail*

I would like to receive news and updates by email

Address*

Religious Affiliation:*

JewishOther

Synagogue affiliation:

Birth Date*

MonthDayYear

I have been approved for funding via:*

What are your unique needs?

Are there any medications or medical information we need to know that would impact your work?

I understand that the program is a life skills employability training program and not emplyoment.*

Yes

List any previous jobs or volunteer work

List 3 things you liked about your previous jobs/volunteer work.

Was there anything you did not like about your previous job/volunteer experience?

What are your strengths?

What are your challenges?

How might your challenges affect your work?

What are your interests?

What are things that you do not enjoy doing?

What are your specific current and emerging work skills?

How often and how many hours would you like to work?

Is there a specific job that you would like to do at the bakery or café?

Please provide any additional feedback here.

Parent/Guardian Information