NJ-Jobs Program Application

  • NJ-JOBS PROGRAM APPLICATION

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  • Welcome to the application for the NJ-JOBS program

    The Judiciary Opportunities for Building Success Program (JOBS) is designed to help
    justice-involved individuals in New Jersey find meaningful employment at a living wage and
    advance their careers.

  • 1. Who referred you
  • Are you 18 or older?
  • Are you or have you been involved in the justice system?
  • If yes in what way?

  • New Jersey Intake And Initial Assessment Form

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  • Today's Date*
     / /
  • Date of Birth*
     - -
  • Gender*
  •  -
  •  -
  • Contact Preference
  • Ethnic Heritage*
  • Marital and Family Status (choose all the apply)*
  • School Status:*
  • Education Level (Choose highest only)*
  • Post-secondary/Vocational/Associates HS Plus (If none applies, leave blank)
  • Employment Status*
  • If employed, are you working:
  • If not employed and homemaker
  • US Citizen*
  • Permanent Resident or Exp. Date (If you're a US Citizen, please skip)
     / /
  • Individual with Disability
  • Housing*

  • Offender Status - Have you been convicted of criminal offense?
  • Assessments: Have you received any of the following in the last six months?

  • Military Service:
  • Service Disability (If you answered no, please skip)
  • Receiving Veteran's benefits or Assistance? (If you answered no, please skip)
  • Military Spouse - Are you:
  • If active duty spouse, has your income been affected by spouse's deployment?
  • Selective Service: (Males born on or after January 1, 1960 only)*
  • Migrant Seasonal Farmworker:*

  • Employment Preferences

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  • The next couple of questions will help our Career Services Department assist you with job placement. Please answer the following questions as if you're applying for a particular job and specifying the type of job you desire, how much you want make, etc...

  • How often would you like to work during the week?*
  • When would you like to start actively looking for a job?*
     / /
  • Are you willing to work any shift?*
  • If no, which shift(s):
  • If you're willing to relocate, how many miles from where you live are you comfortable moving?*

  • Employment History

  • Unemployed: Please fill out at least one of the most recent jobs that you no longer work for.

    Employed: Please fill out your current employment information.

  • Start Date
     / /
  • End Date
     / /
  • Reason for Leaving

  • Start Date
     / /
  • End Date
     / /
  • Reason for Leaving:

  • I attest that the information provided is true and accurate. Any misrepresentation may be ground for termination from program(s). I further understand that being determined eligible for services and/or training does not necessarily entitle me to service/training.
  • Today's Date
     / /
  • Today's Date
     / /
  •  
  • Should be Empty: