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11orl:in <br /> WardrobesCLIENT REFERRAL FORM <br /> Rebuilding Careers <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: Veteran Veteran O Justice ❑Senior (55+) [:]Young Adult ❑Adult <br /> Spouse Involved <br /> INFORMATIONPARTICIPANT <br /> Participant Name: Date: <br /> Phone Number' ❑ Check if ok to text <br /> Email: <br /> Address: <br /> AGENCY/PROGRAMREFERRING <br /> Name of Referring Agency/Program: <br /> Contact Person: <br /> Phone Number: <br /> Email: <br /> Address: <br /> HOW CAN WE HELP? <br /> Career Navigation/Management ❑ Financial Assistance VETERAN SERVICES <br /> (proof of military service and/or <br /> ❑New/Updated Resume ❑ Community& Supportive spouse status required) <br /> Do you have a resume? Yes No <br /> Services Possess Copy of DD 214: ❑Yes❑No <br /> ❑ � <br /> ❑ Legal Services Referral Copy of Marriage Certificate or <br /> Job Leads/Placement Housing Referral DEERS enrollment: ❑Yes❑No <br /> ❑ <br /> ❑ Mock Interview Practice ❑ Veteran Housing Referral <br /> VA/VSO Referral (Claim) <br /> Skills Training (indicate any specific skills you wish to develop) ❑ Behavioral Health Counseling <br /> ❑Certification Training (indicate any specific certificates you wish to complete) <br /> JOB/INDUSTRY <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: Working Wardrobes Career Success Center <br /> ' 2000 L. McFadden Ave, Santa Ana, California 92705 <br /> clientreferral[a Workingwardrobes.org (714)210-2460 (p) I www.workingwardrobes.org <br />