Prosperity Employment Outreach Registration Form

Prosperity Employment Outreach Registration Form

Prosperity EO is committed to helping people secure jobs through individualized case management, job readiness programs, and a range of supportive services. Our focus is on residents of West Texas. We offer various resources to job seekers, specifically those who face obstacles in finding employment on their own. We are not a staffing agency. We work directly with you to overcome barriers and work together for you to find work. Since we're a non-profit organization, our services are either free or very affordable but we reserve the right to refuse service to anyone, at anytime. Not everyone is eligible for our programs and we work heavily by referral.
Client Details:
The below information is kept confidential within our organization and trusted partners. Funding from foundations requires us to ask the following questions:
We EMAIL you back to start the program. Be sure to check your emails. Ours is Admin@prosperityoutreach.org. If you don't hear from us, email us! Look in your spam. But stay connected! Jobs and help go to those who stay connected!*
Select the program options you need:

RESUME ONLYEmployment (resume, mentoring, advocacy, training)Women's Clothing ClosetAll Options (must be willing to participate with all of program and engage )
Do you have steady transportation

YesNoA Ride
Do you have a Valid Driver's License?

YesNo
If no Driver's License, do you have a State ID?

YesNo
Do you live in Midland? If not, where do you live? You must live in Midland to qualify for this program.*
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
How did you hear about our program? Or Who referred you?*
Ladies- We offer Success Suits Her. Which is professional women's clothing! You must be looking for work, ready to interview or need clothing for a professional reason. PLEASE tell me about your clothing needs and sizes needed:*
What is your age?*
What is your race. Please include if more than one.*
What sex do you identify with?*
What's your highest level of education?*
Are you currently employed? Full Time or Part Time?*
What is your income. We do not report to the state or government.*
Do you need help with employment? Fill out the rest of the application, if you do!*
What's the primary language spoke at home? Are you fluent in English or Spanish or another language.*
IF you are wanting our employment and mentoring services- please fill out all the following questions. Without these answers we can't move you into our employment program! It's very important.
Do you have an updated resume, if NOT, see below!

YesNo
Please upload your resume: (this helps us create you a professional resume). IN ORDER TO HELP, I need at least a typed up copy of your jobs and work history. It does NOT have to be pretty or perfect, we will do that. Send what you have. This is required to move on in this form.

Cancelof
2nd resume or certificates

Cancelof
Our program and YOU work together to help you find work. We are NOT a staffing agency. Are you willing to answer calls, texts, emails? Are you willing to schedule interviews?
Candidates will receive a professionally crafted resume if registered for resume or employment program. Requires you to approve it.
Companies TEXT, EMAIL and CALL job seekers. Are you willing to answer your phone and set a voicemail? So many applicants looking for work MISS opportunities because they dodge phone calls. MANY companies/recruiters use an app to block their number and it appears as unknown or spam. You MUST be willing to answer all calls, texts and voicemails. Otherwise- it's a waste of our programs time. Answer below if you are willing.

YesNo
What type of work are you looking for? Be specific.
Do you have experience in the type of work you are looking for?
Are you currently employed? If so, WHERE and what is your MONTHLY INCOME. This is only used for our program and not shared.
Please explain your current employment issues
What drains you at work? Makes you feel overwhelmed or exhausted?
Do you know how to use Zoom on a computer/cell phone? (some training is done on Zoom OR I can send video links, if not)

YesNo
Do you fit into one of these categories to qualify for our program?

UnemployedLack Skills or EducationIlliterate or have difficulty readingLeaving or have gone through an abusive relationship in the last 5 yearsHave been on probation or imprisoned in the last 5 yearsFinancially strugglingUnder Employed (being paid below your worth)None of theseDrug or Alcohol dependency issues
Please tell us why you need our services?
Do you have any certifications, CDL or specialized training?
Are you in need of these services?

Food Insecure (you need food)clothing helpwifi/internet access at homerent/house payment assistancecounseling for abuse, alcohol/drug dependencymedical help or servicesEnglish Classes (reading, writing, speaking English)Learning to readHelp with drug or Alcohol dependency issuesNot Interested
Are you currently working with any other programs in WTX, the state, receiving benefits/cash/gifts, services (this won't count against you).
If YES from above, please include case managers name, what program and their phone number.
Background- Do you have any type of background that we need to be aware of and that we can advocate for you to get work. We work with companies to increase hiring for 2nd chance employees.
Have you completed a drug or alcohol treatment program? Do you have a certification/letter?
Driving Record- Do you have a clean driving record or issues? If you have issues, please let us know what they are so we can better advocate for you to get work!
What type of training would be something that would help you in the future? We have 1000's of DIGITAL trainings and can also create one specifically for you. We do not offer oilfield training.
What is the primary language spoken at home?
Are you fluent in English or Spanish? Or another language?
Will you please refer us to your friends and family? If yes, we will TEXT you a QR code and information to share.

YesNo
Disclaimer:

By finishing and submitting this form, you the client/case, understand that Prosperity Employment Outreach WILL SHARE your information, case file, resume with recruiters, a team of volunteers to assist you including referring to 3rd party counseling services and other nonprofit/company resources, ON YOUR BEHALF. We share your information to advocate for your for employment and other services.

Prosperity Employment Outreach is a non-profit partner in West Texas for personalized case management job support, training, advocating & networking for the job seeker. We've worked with hundreds of companies across the United States as recruiters & creating live recruiting events and can help you find the work you need. We are a West Texas based non-profit and dedicated to helping the citizens of our area thrive. Job Seekers must be moving to West Texas within the next 30 days and have verifyable housing arranged. Candidates will actively play a role in finding employment by submitting applications, interviews and job searches along with P.E.O actively working on your behalf. Job Seekers will participate in 1x weekly training via cell phone or computer. Job Seekers must complete a training intro module to receive their updated resume.
BELOW IS FOR OFFICE USE ONLY - Office Submission

Yes
Which services have been completed for the client case?
Office Notes
Should be Empty: