NextSuccess Interest Form

NextSuccess Interest Form
AAWDC NEXTSuccess is here with jobs, internships, and trainings waiting for you! It's your personalized guide to discovering your career path and preparing for the future. Young Adults ages 18-24 can connect to services by completing the interest form below.
Name *

First Name Last Name
Date of Birth *

Month Day Year
Date
Cell Phone Number *
Please enter a valid phone number.
Do you want to receive texts about NextSuccess? *

Yes No
Email *
example@example.com
Are you an Anne Arundel County resident? *

Yes No
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Please upload proof of your address. Acceptable documents include driver's license, voter registration card, computer printout from government agency, food stamp award letter, Housing Authority letter, current lease, public assistance records, or current year school ID. *

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Are you eligible to work in the US? *

Yes No
Please upload proof of eligibility to work in the US. Acceptable documents include birth certificate, voter's registration card, US passport, Alien Registration card, food stamp records, Naturalization certificate, or public assistance records. *

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What industries are you interested in? (Please select all that apply) *

Healthcare IT/Cybersecurity Transportation, Warehousing, Logistics Construction Hospitality, Food Service, Retail Other
Please upload a copy of your resume if you have one.

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Are you currently enrolled in any other workforce programs? (Please select all that apply) *

SNAP TANF Unemployment Insurance Division of Rehabilitation Services (DORS) None of the Above
Please select any of the challenges below that make it difficult for you to find employment. *

Transportation Issues Homeless Disability Childcare Justice Involved None of the Above Other
How did you hear about NextSuccess?

Family/Friend Member Faith-Based Organization Social Media Radio/Spotify Website Community Organization/State Agency Other
What Community Organization/State Agency did you learn about NextSuccess from?
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