Senior Community Service Employment Program (SCSEP) Application

Senior Community Service Employment Program (SCSEP) Application

Complete this one-page application for MET Inc.’s SCSEP program—provide accurate information and required details.
Full Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
County
Age
Are you age 55 or older?
Are you currently unemployed, or working fewer hours than needed for self-sufficiency?
Are you a U.S. citizen, national, or otherwise authorized to work in the United States?
Are you a resident of the county/service area listed above?
If required, are you registered for Selective Service (males born after 12/31/1959)?
Number of persons in family (including applicant)
Total annual family income (all sources, before taxes)
Select your family size to view the income limit that applies to you
Figures reflect 125% of the 2026 HHS Poverty Guidelines for the 48 contiguous states and D.C.
Priority & Barrier-to-Employment Factors (check all that apply)
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Signature

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: