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11orl:in <br />Wardrobes <br />Rebuilding Careers <br />CLIENT REFERRAL FORM <br />Working Wardrobes' Client Services Team supports working age individuals with a variety of <br />workforce readiness services and linkages to community resources in an environment of dignity <br />and respect. You can refer someone you know or fill out the information below for yourself. A <br />member of our team will follow up with you regarding next steps. <br />Client Type:11 Veteran ❑ Veteran O Justice ❑ Senior (55+) Young Adult ❑ Adult <br />Spouse Involved <br />Participant Name: <br />Phone Number: - <br />Email: <br />Address: <br />Name of Referring Agency/Program: <br />Contact Person: <br />Phone Number: <br />Email: <br />Address: <br />❑ Career Navigation/Management <br />New/Updated Resume <br />Do you have a resume?❑Yes No <br />❑ Job Leads/Placement <br />❑ Mack Interview Practice <br />Financial Assistance <br />Community & Supportive <br />Services <br />Legal Services Referral <br />❑ Housing Referral <br />Skills Training (indicate any specific skills you wish to develop) <br />Date: <br />❑ Check if ok to text <br />VETERAN SERVICES <br />(proof of military service and/or <br />spouse status required) <br />Possess Copy of DD 214: ElYesONo <br />Copy of Marriage Certificate or <br />DEERS enrollment: Yes []No <br />❑ Veteran Housing Referral <br />VA/VSO Referral (Claim) <br />1J Behavioral Health Counseling <br />❑ Certification Training (indicate any specific certificates you wish to complete) <br />I am unsure about what type of job/industry I want. <br />I have a good idea what type of job/industry I want. (job/industry): <br />❑ I am looking to transition from one job/industry to another. <br />(current job/industry): <br />(desired job/industry): <br />Email Referral To: <br />clientreferral Workingwardrobes.org <br />Working Wardrobes Career Success Center <br />2000 L. McFadden Ave, Santa Ana, California 92705 <br />(714)210-2460 (p) I www.workingwardrobes.org <br />