RAISE Application Form | Jewish Federation of Greater Orlando

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

How should we contact you? *

Are you 18 years old or older? *

Are you currently employed? *

Do you want to work in the community after completing the RAISE program? *

Are you currently working with Vocational Rehabilitation? *

Who is your VR counselor? *

Tell us about your educational background *

Additional comments

How did you hear about RAISE? *

RAISE requires each applicant to have a Family Liaison, (usually a family member) who lives locally and is able to attend the interview, occasional programs, and is willing to meet for conferences if necessary.

Do you have a family member willing to participate in RAISE as a Liaison? *

Liaison's Name *

First

Last

Relationship to Applicant *

Liaison's Email *

Liaison's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Liaison's Phone *

Being a RAISE employee requires you to have transportation to work sites 3 times a week.

Do you have transportation to a work site 3 times per week? *

Are there any additional comments you would like to share with us?

By submitting this application you grant RAISE permission to contact any persons or entities listed on your application to discuss your potential involvement in our program.