LifeWorks Participant Application

Qualifications for Participation in the LifeWorks Class

High School diploma or GED
U.S. citizenship or "right to work"
Stable housing
Reliable transportation
Ability to read/write/speak English
No felonies in past 5 years
No current drug/alcohol addictions
Commitment to change
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LifeWorks Participant Application

Please complete the form below.
Desired Training Site (Select One)*
Scroll to the top for list of training sites
Are you interested in attending LifeWorks virtually (online)? A JP staff member can help determine if you meet the qualifications.

Yes, I'm interested in attending virtually (online)
Was this participant moved to a virtual class?

YesNo
Salutation*
Name*

First NameLast Name
Current Address*

Street Address

Street Address Line 2

CityState / Province

Zip Code
Cell Phone Number*
Please enter a valid phone number.
Important class updates are sent via email. Please list your preferred email address.
Email Address*
example@example.com
Your preferred method of contact (select all that apply):

TextEmailPhone
In what industry are you currently interested?*

Advanced ManufacturingConstruction (trades) & UtilitiesHealthcare (clinical and non clinical)HospitalityInformation Technology & FinanceTrade & LogisticsOther
If "Other" (to industry of interest), specify the industry in which you are currently interested.*
An intake call is necessary for enrollment. Please choose a day and time below that works best for you.
Preferred day for intake call (Select all that apply):*

Tuesday 8am-12pmTuesday 1pm-6pmThursday 8am-12pmThursday 1pm-6pm
Preferred time of day for intake call.
Enter a time or time range
Date of Birth*

MonthDayYear
Date
Social Security Number (last 4)
Gender*

MaleFemale
Referral Source*
How did you hear about Jobs Partnership?
If Jobs Partnership Graduate, Word of Mouth or Church, please provide the name of the person or church.
Do you have a high school diploma or GED?*
Do you have a smart phone with WiFi capabilities or access to technology?*
Do you have access to a computer or tablet and WiFi?*
BACKGROUND SCREENING INFORMATION

As a general rule, Jobs Partnership requires that participants do not have prior felony convictions within the last 5 years. Jobs Partnership does not accept participants with any prior convictions that are violent or sexual in nature. Please provide accurate and complete information regarding your criminal background. Inaccurate information may result in dismissal from the program. However, exceptions are made for our community partners.
Have you been convicted of a felony?*
If yes, when? (Felony)

MonthDayYear
If yes, please explain. (Felony)
Have you been convicted of a misdemeanor?*
If yes, when? (Misdemeanor)

MonthDayYear
If yes, please explain. (Misdemeanor)
Do you have any drug or alcohol addictions?*
Do you have stable housing? *
Are you a US citizen or do you have the right to work in the US?*
Do you have the ability to read, write, and speak in English?*
Are you committed to change?*
Are you interested in accelerated skills training?*

YesNo
If yes, which program?
I grant The Jobs Partnership of Florida permission to capture and utilize photographs/videos of me during Jobs Partnership classes and events. These images/videos may be used for promotional purposes on social media, the organization's website, and printed documents.*

YesNo
Do you have reliable transportation for all 12 weeks of the program classes and events?*

Yes, I have access to a car/I own a carYes, I plan to use public transportation/bus/Uber/LyftNo
I understand the following:
- The LifeWorks Program spans 12 weeks, starting on Febuary 18th or 20th (depending on site selection), and concluding on May 13th or May 15th.
- Special events are held on Mondays throughout this 12-week period.
- Attendance is expected for all LifeWorks classes and events.
Do you understand and agree to the above statements?*

Yes, I understand and agreeI cannot commit to these requirements
An intake call is required to complete the enrollment process. Please choose a day and time below that works best for you. After scheduling your call, please make sure to click the "Submit" button below to complete your application.
Please click "Submit" below to complete your application.
Program
Application Name
Used to set the name on the application
Program SF ID
Signature of Student*

Clear
Date Signed*

MonthDayYear
Date
Planned Orientation Date

Tuesday, February 13th at 9am-10am (Dream Center)Tuesday, February 13th from 2:30pm-3:30pm (Evans)Tuesday, February 13th at 6pm-7pm (Virtual Class)Thursday, February 15th at 6pm-7pm (FBO, Summit, St. Paul's)
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LifeWorks Participant Application

An intake call is necessary for enrollment. Please choose a day and time below that works best for you.

Please click "Submit" below to complete your application.