Disability Network Northern Michigan Intro to Job Club Registration Form

Disability Network Northern Michigan Job Club Registration Form
Job Club: Employment Series

Employment series will assist individuals to explore employment skills and broaden their abilities to prepare for employment. Topics and activities covered in this series include Job Search, Accommodations & Disclosure, Understanding Employment Skills, Interviews and Applications, Self-Employment, Resume and Cover Letter, Interviewing Skills, and Social Security Benefits Planning.

Space is limited for individuals registering. It is preferred and highly recommended that individuals commit to all scheduled days of the employment series.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Are you 18 year's old or older?
Date of Birth

MonthDayYear
Date
Disability Information: our programs and services are for individuals with disabilities.
What is your primary disability? list any disability you are willing to disclose
Do you require any accommodations?
Technology
Device you will be using?
Have you used zoom before?
Do you need help learning or connecting to zoom?
Please share any other information or questions you may have?
Job Club Activity Materials
Do you give Disability Network permission to mail your materials for group activities using the address above?
Please use the space below for any additional information you would like to share with staff. Staff will be in contact with you after recieving your registration.
Should be Empty:

Disability Network Northern Michigan Job Club Registration Form

Disability Information: our programs and services are for individuals with disabilities.

Technology

Job Club Activity Materials