Isaacs Education and Workforce Enrollment Form (updated)

Your Journey Begins Here!

Thank you for choosing to develop your employment and education skills at the Isaacs Center. We are happy that you have begun the process of joining our program.

The mission of the Education and Workforce program is to prepare you for success and self-sufficiency by creating learning opportunities, connecting youth to resources, and providing individualized support.

We hope to empower you to accomplish your employment, educational, and personal goals. This program is more than an employment & education program; in addition to your professional development, we will work with you to develop critical life skills that enhance your personal well-being, personal responsibility, confidence and decision- making skills.

Through this process we hope you learn to trust us, but more importantly trust yourself, as you begin these important next steps.
Your Full Legal Name

Legal First NameLegal Last Name
Preferred Name

Preferred First NamePreferred Last Name
Application ID
This can be found in the email confirmation from your program interest form. Reach out to EWinfo@isaacscenter.org if you need this.
Please tell us what joining this program means to you and for your future?
What additional services are you interested in receiving? Check all that apply.
Help with benefits/public assistance
Help with housing
Help with family concerns
Help with legal issues
Help with court of any type
Help with ACS case(s)
Help with state Id card
Help with educational goals
Help with GED preparation
Help with college apps and financial aid
Help with SAT preparation
Help with additional job training
Help with SNAP (food stamps)
LGBTQ support services
Fatherhood services
Immigrant services
Senior services
Childcare services
Medicaid services
Help with other
Social Security Number
Follow the format
Gender Identity
Address

Street Address

Street Address Line 2

CityState

Zip Code
Appartment Number
Do you currently live in a NYCHA Development?
What is the name of the development?
Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Ethnicity
Race
Are you legally married?
Do you have children?
What languages do you speak?
Country of Origin
Emergency Contacts

Please provide us with the names and contact information of the people we should contact in the event of an emergency.
Emergency Contact First and Last Name
Emergency Contact Relationship
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
2nd Emergency Contact First and Last Name
2nd Emergency Contact Relationship
2nd Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Highest Grade Completed
Most Recent School Attended
Major
Attendance Start Date

MonthDayYear
Date
Attendance End Date

MonthDayYear
Date
Most Recent Employer
Most Recent Employment Start Date

MonthDayYear
Date
Most Recent Employment End Date

MonthDayYear
Date
Hourly Wage (USD)
I, the undersigned, of legal age OR the parent/guardian of the undersigned, consent to the use and reproduction of any photographs, film and/or video taken by or on behalf of the Stanley M. Isaacs Neighborhood Center, Inc./Goddard Riverside I understand that this media may be used to promote the Stanley M. Isaacs Neighborhood Center, Inc./Goddard Riverside. As such, I consent to the use of my name, portrait or photograph by the Isaacs Center for advertising, educational use, publicity use, and trade purposes, in any/all media, including but not limited to television, radio, and publications—print and digital.
Applicant Signature
Date

MonthDayYear
Date
Parent Signature
Date

MonthDayYear
Date
To the best of my knowledge the information above is true. I agree to its verification and understand that falsification may be grounds for termination of service. Information provided may be used by the agency for reporting data and to city of New York to improve city services or to access additional funding.
Participant Signature
Date

MonthDayYear
Date
Parent/Guardian Acknowledgement
I give permission for the aforementioned to attend Education and Workforce Programming at the Isaacs Center. I agree to its verification and understand that falsification may be grounds for termination of service. Information provided may be used by the agency for reporting data and to city of New York to improve city services or to access additional funding.
Parent/Guardian Signature
Date

MonthDayYear
Date
Please upload CLEAR copies of the documents below.

If you have any issues uploading OR do not have access to the requested documents, please ask an Education and Workforce team member for support or email us at EWINFO@isaacscenter.org.
Photo ID - Please upload a clear copy of one of the following: State ID | Passport | School ID | ID NYC

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Please upload a clear copy of your birth certificate.

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Please upload your proof of address MUST BE DATED WITHIN THE LAST SIX MONTHS. DATE MUST BE VISIBLE: Utility Bill | Current Lease | Cable Bill w Phone Service Listed | Cell Bill with Address Visible | Official Mail from a Federal, State, or City Agency

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Please upload your proof of vaccination

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Please upload a copy of your social security card.

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Please upload your resume.

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Please upload your high school diploma.

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Should be Empty:

Emergency Contacts

Parent/Guardian Acknowledgement